000284361 001__ 284361 000284361 005__ 20260130151745.0 000284361 0247_ $$2doi$$a10.1007/s00702-025-03096-7 000284361 0247_ $$2pmid$$apmid:41484430 000284361 0247_ $$2ISSN$$a0375-9245 000284361 0247_ $$2ISSN$$a0022-3026 000284361 0247_ $$2ISSN$$a0300-9564 000284361 0247_ $$2ISSN$$a1435-1463 000284361 037__ $$aDZNE-2026-00129 000284361 041__ $$aEnglish 000284361 082__ $$a610 000284361 1001_ $$00000-0002-2854-4179$$aFanciulli, Alessandra$$b0 000284361 245__ $$aHow to treat cardiovascular autonomic failure in Parkinson's disease. 000284361 260__ $$aWien [u.a.]$$bSpringer$$c2026 000284361 3367_ $$2DRIVER$$aarticle 000284361 3367_ $$2DataCite$$aOutput Types/Journal article 000284361 3367_ $$0PUB:(DE-HGF)16$$2PUB:(DE-HGF)$$aJournal Article$$bjournal$$mjournal$$s1769782587_8942$$xReview Article 000284361 3367_ $$2BibTeX$$aARTICLE 000284361 3367_ $$2ORCID$$aJOURNAL_ARTICLE 000284361 3367_ $$00$$2EndNote$$aJournal Article 000284361 520__ $$aCardiovascular autonomic failure is a frequent non-motor feature of Parkinson's disease (PD) that affects up to one third of individuals from the premotor to the advanced stages of the disease, with major diagnostic, therapeutic and prognostic implications. It may manifest with orthostatic, post-prandial or exercise-induced hypotension, as well as hypertensive episodes in the supine position during wakefulness or nocturnal sleep. Hypotensive episodes may remain asymptomatic or manifest with symptoms of end-organ hypoperfusion in the upright position, after meals or during exertion that may include lightheadedness, blurred vision, cognitive slowness, shuffling gait, back pain, fatigue or, in severe cases, syncope. Supine and nocturnal hypertension are likewise often asymptomatic, yet may cause nocturnal polyuria, and disrupt sleep through frequent nocturnal toilet visits. Bedside screening for cardiovascular autonomic failure relies on targeted history taking, eventually supported by validated questionnaires, and supine to standing heart rate and blood pressure measurements. A more detailed assessment is obtained with cardiovascular autonomic function tests under continuous, non-invasive, hemodynamic monitoring, complemented by 24-hours ambulatory blood pressure monitoring and home blood pressure diaries. Hypotensive episodes are managed by addressing potential triggers, such as infections, anemia, dehydration and polypharmacy, followed by a stepwise implementation of behavioral, non-pharmacological and pharmacological strategies. Individuals with orthostatic hypotension should be constantly monitored for concomitant supine and nocturnal hypertension, especially if treatment with pressor agents has been recently started. Hypertensive episodes are likewise treated in a stepwise fashion with preventive, non-pharmacological and pharmacological measures, prioritizing hypotension control during daytime and mitigating hypertension overnight. 000284361 536__ $$0G:(DE-HGF)POF4-353$$a353 - Clinical and Health Care Research (POF4-353)$$cPOF4-353$$fPOF IV$$x0 000284361 588__ $$aDataset connected to CrossRef, PubMed, , Journals: pub.dzne.de 000284361 650_7 $$2Other$$aNocturnal hypertension 000284361 650_7 $$2Other$$aOrthostatic hypotension 000284361 650_7 $$2Other$$aParkinson’s disease 000284361 650_7 $$2Other$$aPost-prandial hypotension 000284361 650_7 $$2Other$$aSupine hypertension 000284361 650_2 $$2MeSH$$aHumans 000284361 650_2 $$2MeSH$$aParkinson Disease: complications 000284361 650_2 $$2MeSH$$aAutonomic Nervous System Diseases: etiology 000284361 650_2 $$2MeSH$$aAutonomic Nervous System Diseases: therapy 000284361 650_2 $$2MeSH$$aAutonomic Nervous System Diseases: diagnosis 000284361 650_2 $$2MeSH$$aCardiovascular Diseases: therapy 000284361 650_2 $$2MeSH$$aCardiovascular Diseases: etiology 000284361 650_2 $$2MeSH$$aCardiovascular Diseases: diagnosis 000284361 7001_ $$00000-0003-1714-5305$$aLeys, Fabian$$b1 000284361 7001_ $$0P:(DE-2719)2811373$$aHöglinger, Günter$$b2 000284361 7001_ $$00000-0002-8574-3297$$aJost, Wolfgang H$$b3 000284361 773__ $$0PERI:(DE-600)1481655-6$$a10.1007/s00702-025-03096-7$$gVol. 133, no. 2, p. 215 - 228$$n2$$p215 - 228$$tJournal of neural transmission$$v133$$x0375-9245$$y2026 000284361 8564_ $$uhttps://pub.dzne.de/record/284361/files/DZNE-2026-00129.pdf$$yRestricted 000284361 8564_ $$uhttps://pub.dzne.de/record/284361/files/DZNE-2026-00129.pdf?subformat=pdfa$$xpdfa$$yRestricted 000284361 9101_ $$0I:(DE-588)1065079516$$6P:(DE-2719)2811373$$aDeutsches Zentrum für Neurodegenerative Erkrankungen$$b2$$kDZNE 000284361 9131_ $$0G:(DE-HGF)POF4-353$$1G:(DE-HGF)POF4-350$$2G:(DE-HGF)POF4-300$$3G:(DE-HGF)POF4$$4G:(DE-HGF)POF$$aDE-HGF$$bGesundheit$$lNeurodegenerative Diseases$$vClinical and Health Care Research$$x0 000284361 915__ $$0StatID:(DE-HGF)3002$$2StatID$$aDEAL Springer$$d2025-01-02$$wger 000284361 915__ $$0StatID:(DE-HGF)3002$$2StatID$$aDEAL Springer$$d2025-01-02$$wger 000284361 915__ $$0StatID:(DE-HGF)0200$$2StatID$$aDBCoverage$$bSCOPUS$$d2025-01-02 000284361 915__ $$0StatID:(DE-HGF)0300$$2StatID$$aDBCoverage$$bMedline$$d2025-01-02 000284361 915__ $$0StatID:(DE-HGF)0100$$2StatID$$aJCR$$bJ NEURAL TRANSM : 2022$$d2025-01-02 000284361 915__ $$0StatID:(DE-HGF)0600$$2StatID$$aDBCoverage$$bEbsco Academic Search$$d2025-01-02 000284361 915__ $$0StatID:(DE-HGF)0030$$2StatID$$aPeer Review$$bASC$$d2025-01-02 000284361 915__ $$0StatID:(DE-HGF)0199$$2StatID$$aDBCoverage$$bClarivate Analytics Master Journal List$$d2025-01-02 000284361 915__ $$0StatID:(DE-HGF)1050$$2StatID$$aDBCoverage$$bBIOSIS Previews$$d2025-01-02 000284361 915__ $$0StatID:(DE-HGF)0160$$2StatID$$aDBCoverage$$bEssential Science Indicators$$d2025-01-02 000284361 915__ $$0StatID:(DE-HGF)1030$$2StatID$$aDBCoverage$$bCurrent Contents - Life Sciences$$d2025-01-02 000284361 915__ $$0StatID:(DE-HGF)1190$$2StatID$$aDBCoverage$$bBiological Abstracts$$d2025-01-02 000284361 915__ $$0StatID:(DE-HGF)0113$$2StatID$$aWoS$$bScience Citation Index Expanded$$d2025-01-02 000284361 915__ $$0StatID:(DE-HGF)0150$$2StatID$$aDBCoverage$$bWeb of Science Core Collection$$d2025-01-02 000284361 915__ $$0StatID:(DE-HGF)9900$$2StatID$$aIF < 5$$d2025-01-02 000284361 9201_ $$0I:(DE-2719)1111015$$kClinical Research (Munich)$$lClinical Research (Munich)$$x0 000284361 980__ $$ajournal 000284361 980__ $$aEDITORS 000284361 980__ $$aVDBINPRINT 000284361 980__ $$aI:(DE-2719)1111015 000284361 980__ $$aUNRESTRICTED