Clinical and neurohormonal characteristics in African Americans with neurogenic orthostatic hypotension

Richard J. Giza; Maureen C. Farrell; Amy C. Arnold; Italo Biaggioni; Cyndya A. Shibao

doi:10.1007/s10286-020-00764-4

Clinical and neurohormonal characteristics in African Americans with neurogenic orthostatic hypotension

Richard J. Giza, Maureen C. Farrell, Amy C. Arnold, Italo Biaggioni Cyndya A. Shibao

Clinical autonomic research, v 31(1), pp 101-107

01 Feb 2021

: https://doi.org/10.1007/s10286-020-00764-4

: 33502643

(1)

url

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9014397

Accepted (AM)

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.

: Clinical and neurohormonal characteristics in African Americans with neurogenic orthostatic hypotension
: Richard J. Giza - Drexel University
Maureen C. Farrell - Drexel University
Amy C. Arnold - Penn State Milton S. Hershey Medical Center
Italo Biaggioni - Vanderbilt University Medical Center
Cyndya A. Shibao - Vanderbilt University Medical Center
: Clinical autonomic research, v 31(1), pp 101-107
: Springer Nature
: 7
: Journal article
: English
: College of Medicine
: WOS:000612244500001
: 2-s2.0-85099754880
: 991021860759004721

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esploro.research.conf.research.portal.label.prefix.inciteCollaboration: research.portal.fulldisplay.incitesHighlights.institutionCollaboration
esploro.research.conf.research.portal.label.prefix.inciteWOSResearchAreas: Clinical Neurology; Neurosciences