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Clinical and neurohormonal characteristics in African Americans with neurogenic orthostatic hypotension
Journal article   Open access   Peer reviewed

Clinical and neurohormonal characteristics in African Americans with neurogenic orthostatic hypotension

Richard J. Giza, Maureen C. Farrell, Amy C. Arnold, Italo Biaggioni and Cyndya A. Shibao
Clinical autonomic research, v 31(1), pp 101-107
01 Feb 2021
PMID: 33502643
url
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9014397View

Abstract

Clinical Neurology Life Sciences & Biomedicine Neurosciences Neurosciences & Neurology Science & Technology
Purpose Neurogenic orthostatic hypotension (nOH) is the hallmark of neurodegenerative forms of autonomic failure, including pure autonomic failure, multiple system atrophy, and Parkinson's disease. Studies have shown autonomic physiological differences in Africans Americans (AA) such as lower heart rate variability, enhanced blood pressure reactivity, and blunted sympathetic neural response compared to non-Hispanic whites. However, the clinical characteristics and neurohormonal profile of autonomic failure in AA is unknown. Methods A total of 65 patients with nOH participated in this study (9 AA and 56 non-Hispanic whites). Both groups were of similar age and comorbidity status, and they underwent standardized autonomic testing and assessment of neurohormonal levels and renin activity and aldosterone in supine and upright positions. Results There were no significant differences in baseline autonomic clinical characteristics between non-Hispanic whites and AA with nOH. Non-Hispanic whites demonstrated a significant increase in upright renin activity compared to AA (295 +/- 88% vs. 13 +/- 13%, respectively). AA showed a blunted increase in aldosterone compared to non-Hispanic whites (188 +/- 27% vs. 59 +/- 38%, respectively). These results indicated persistent suppression of the renin-angiotensin system in AA, particularly during upright posture. Conclusion Our findings demonstrate that AA with nOH have similar clinical characteristics and hemodynamic autonomic profiles, but lower upright renin activity and aldosterone levels, compared to non-Hispanic whites. Renin suppression persists in AA with severe autonomic failure and can potentially contribute to postural changes and supine hypertension.

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Collaboration types
Domestic collaboration
Web of Science research areas
Clinical Neurology
Neurosciences
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