Heat‐related morbidity in patients with orthostatic hypotension and primary autonomic failure
Identifieur interne : 000401 ( France/Analysis ); précédent : 000400; suivant : 000402Heat‐related morbidity in patients with orthostatic hypotension and primary autonomic failure
Auteurs : Atul Pathak [France] ; Maryse Lapeyre-Mestre [France] ; Jean-Louis Montastruc [France] ; Jean-Michel Senard [France]Source :
- Movement Disorders [ 0885-3185 ] ; 2005-09.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Autonomic Nervous System Diseases (epidemiology), Autonomic Nervous System Diseases (etiology), Complication, Diseases of the autonomic nervous system, Female, Heat Exhaustion (complications), Heat Exhaustion (epidemiology), Human, Humans, Hypotension, Orthostatic (epidemiology), Lewy Body Disease (epidemiology), Lewy Body Disease (etiology), Male, Morbidity, Multiple System Atrophy (epidemiology), Multiple System Atrophy (etiology), Nervous system diseases, Parkinsonian Disorders (epidemiology), Parkinsonian Disorders (etiology), Prevalence, heat exposure, orthostatic hypotension, primary autonomic failure, severe adverse event.
- MESH :
- complications : Heat Exhaustion.
- epidemiology : Autonomic Nervous System Diseases, Heat Exhaustion, Hypotension, Orthostatic, Lewy Body Disease, Multiple System Atrophy, Parkinsonian Disorders.
- etiology : Autonomic Nervous System Diseases, Lewy Body Disease, Multiple System Atrophy, Parkinsonian Disorders.
- Aged, Aged, 80 and over, Female, Humans, Male, Prevalence.
Abstract
We investigated the effects of high‐external‐temperature exposure on neurogenic orthostatic hypotension (OH). Thirty‐one patients with autonomic failure (AF) and pharmacologically treated OH related to probable multiple‐system atrophy (n = 7), Parkinson's disease (n = 10), pure autonomic failure (n = 7), and diffuse Lewy body disease (n = 7) and 26 parkinsonians without AF were included. Prevalence and severity of clinical events were studied during the August 2003 heat wave and the 2004 summer. The prevalence of OH‐related events was significantly higher in 2003 [45.1 vs. 11.5%; P = 0.0052; OR = 6.31 (1.35–33.53)] and 2004 [42.3 vs. 12.0%; P = 0.014; OR = 5.40 (1.28–22.68)] in AF than in controls. The mean severity score for clinical events was significantly higher in AF than in controls during 2003 heat wave (1.2 ± 1.4 vs. 0.2 ± 0.5) but similar in summer 2004 (0.7 ± 1.0 vs. 0.1 ± 0.3). Severe events (unusual home care, assistance, or hospitalization) were only observed in AF patients. A nonstatistically significant higher prevalence of clinical events was observed in AF patients prescribed fludrocortisone (66.7%) by comparison to heptaminol (42.9%), midodrine (45.5%), or midodrine plus fludrocortisone (28.6%). This study shows that AF patients have a poor clinical outcome when exposed to high temperatures and that heat exposure is a risk factor for OH worsening. © 2005 Movement Disorder Society
Url:
DOI: 10.1002/mds.20571
Affiliations:
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ISTEX:B4E03D312E00F65CA5467651371954E6432022C5Le document en format XML
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level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2005-09">2005-09</date><biblScope unit="vol">20</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1213">1213</biblScope><biblScope unit="page" to="1219">1219</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">B4E03D312E00F65CA5467651371954E6432022C5</idno><idno type="DOI">10.1002/mds.20571</idno><idno type="ArticleID">MDS20571</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Autonomic Nervous System Diseases (epidemiology)</term><term>Autonomic Nervous System Diseases (etiology)</term><term>Complication</term><term>Diseases of the autonomic nervous system</term><term>Female</term><term>Heat Exhaustion (complications)</term><term>Heat Exhaustion (epidemiology)</term><term>Human</term><term>Humans</term><term>Hypotension, Orthostatic (epidemiology)</term><term>Lewy Body Disease (epidemiology)</term><term>Lewy Body Disease (etiology)</term><term>Male</term><term>Morbidity</term><term>Multiple System Atrophy (epidemiology)</term><term>Multiple System Atrophy (etiology)</term><term>Nervous system diseases</term><term>Parkinsonian Disorders (epidemiology)</term><term>Parkinsonian Disorders (etiology)</term><term>Prevalence</term><term>heat exposure</term><term>orthostatic hypotension</term><term>primary autonomic failure</term><term>severe adverse event</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Heat Exhaustion</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Autonomic Nervous System Diseases</term><term>Heat Exhaustion</term><term>Hypotension, Orthostatic</term><term>Lewy Body Disease</term><term>Multiple System Atrophy</term><term>Parkinsonian Disorders</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Autonomic Nervous System Diseases</term><term>Lewy Body Disease</term><term>Multiple System Atrophy</term><term>Parkinsonian Disorders</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Male</term><term>Prevalence</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Complication</term><term>Homme</term><term>Morbidité</term><term>Système nerveux autonome pathologie</term><term>Système nerveux pathologie</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We investigated the effects of high‐external‐temperature exposure on neurogenic orthostatic hypotension (OH). Thirty‐one patients with autonomic failure (AF) and pharmacologically treated OH related to probable multiple‐system atrophy (n = 7), Parkinson's disease (n = 10), pure autonomic failure (n = 7), and diffuse Lewy body disease (n = 7) and 26 parkinsonians without AF were included. Prevalence and severity of clinical events were studied during the August 2003 heat wave and the 2004 summer. The prevalence of OH‐related events was significantly higher in 2003 [45.1 vs. 11.5%; P = 0.0052; OR = 6.31 (1.35–33.53)] and 2004 [42.3 vs. 12.0%; P = 0.014; OR = 5.40 (1.28–22.68)] in AF than in controls. The mean severity score for clinical events was significantly higher in AF than in controls during 2003 heat wave (1.2 ± 1.4 vs. 0.2 ± 0.5) but similar in summer 2004 (0.7 ± 1.0 vs. 0.1 ± 0.3). Severe events (unusual home care, assistance, or hospitalization) were only observed in AF patients. A nonstatistically significant higher prevalence of clinical events was observed in AF patients prescribed fludrocortisone (66.7%) by comparison to heptaminol (42.9%), midodrine (45.5%), or midodrine plus fludrocortisone (28.6%). This study shows that AF patients have a poor clinical outcome when exposed to high temperatures and that heat exposure is a risk factor for OH worsening. © 2005 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>France</li></country><settlement><li>Toulouse</li></settlement></list><tree><country name="France"><noRegion><name sortKey="Pathak, Atul" sort="Pathak, Atul" uniqKey="Pathak A" first="Atul" last="Pathak">Atul Pathak</name></noRegion><name sortKey="Lapeyre Estre, Maryse" sort="Lapeyre Estre, Maryse" uniqKey="Lapeyre Estre M" first="Maryse" last="Lapeyre-Mestre">Maryse Lapeyre-Mestre</name><name sortKey="Montastruc, Jean Ouis" sort="Montastruc, Jean Ouis" uniqKey="Montastruc J" first="Jean-Louis" last="Montastruc">Jean-Louis Montastruc</name><name sortKey="Pathak, Atul" sort="Pathak, Atul" uniqKey="Pathak A" first="Atul" last="Pathak">Atul Pathak</name><name sortKey="Senard, Jean Ichel" sort="Senard, Jean Ichel" uniqKey="Senard J" first="Jean-Michel" last="Senard">Jean-Michel Senard</name><name sortKey="Senard, Jean Ichel" sort="Senard, Jean Ichel" uniqKey="Senard J" first="Jean-Michel" last="Senard">Jean-Michel Senard</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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