EUROPE AND USA: AGREEMENT ON DEFINITION AND DIAGNOSIS OF SPECIFIC FORM OF HIGH BLOOD PRESSURE

Physician from Karl Landsteiner University of Health Sciences plays a part in global consensus-building process

Krems (Austria), 6 November 2018 – A transcontinental agreement was recently reached on the definition and diagnosis of a particular form of high blood pressure. Until now, it was difficult to outline a generally accepted set of symptoms – and therefore to diagnose – this type of high blood pressure, which is known as neurogenic supine hypertension. With the publication of a consensus statement, two major medical associations – one European and one American – have now come to an agreement on the subject. A physician from Karl Landsteiner University of Health Sciences was involved in forming this consensus in his role of President of the European body.

Medical experts have agreed on the definition and diagnosis of a condition known as supine hypertension. This refers to high blood pressure that occurs when the sufferer is in a recumbent position. This is often caused by neurodegenerative conditions such as Parkinson’s, which attack the autonomic nervous system and in turn the mechanism controlling the cardiac muscle. Supine hypertension can lead to strokes, brain haemorrhages and heart attacks. In view of these potentially fatal consequences, a clear definition of the symptoms and timely diagnosis of the condition is essential. But until recently, no international standard was in place.

SIGNIFICANT PRESSURE TO REACH AGREEMENT

Speaking about this joint success for the European Federation of Autonomic Societies (EFAS) and the American Autonomic Society (AAS), EFAS President Prof. Struhal commented: “This consensus was urgently needed, because large numbers of patients suffering from neurodegenerative conditions are also affected by circulatory dysregulation. Diagnosing such dysfunctions, which include supine hypertension, is simple, but there is little awareness of them. And of course, recognising the conditions is a prerequisite for effective treatment.”

Autonomic nervous system disorders, some of which are extremely rare “orphan diseases”, pose particular challenges for neurologists, and represent a pioneering research topic. Structured recommendations related to these illnesses was only possible thanks to specialist organisations joining forces in EFAS and their effective collaboration with the AAS.

SUCCESSFUL PARTNERSHIP

The criteria apply to patients suffering from orthostatic hypotension – a form of low blood pressure that can lead to high pressure when the patient lies down, due to the condition’s impact on the autonomic nervous system. The consensus defines systolic blood pressure of more than 140mm Hg and/or diastolic blood pressure of more than 90mm Hg as an indication of supine hypertension, measured after at least five minutes of rest in a recumbent position. Criteria have also been defined which allow for distinctions to be made between mild, moderate and severe forms of the disease.

In Prof. Struhal’s view as an expert in autonomic disorders, a strong willingness to cooperate was the defining feature of the collaboration with numerous international colleagues. By contributing to the transcontinental consensus-building process, KL Krems again underscored and further enhanced the international reputation of its medical specialists.

Original publication: Consensus statement on the definition of neurogenic supine hypertension in cardiovascular autonomic failure by the American Autonomic Society (AAS) and the European Federation of Autonomic Societies (EFAS). A. Fanciulli, J. Jordan, I. Biaggioni, G. Calandra–Buonaura, W. P. Cheshire, P. Cortelli, S. Eschlboeck, G. Grassi, M. J. Hilz, H. Kaufmann, H. Lahrmann, G. Mancia, G. Mayer, L. Norcliffe–Kaufmann, A. Pavy–Le Traon, S. R. Raj, D. Robertson, I. Rocha, W. Struhal, R. Thijs, K. P. Tsioufis, J. G. van Dijk, G. K. Wenning Clinical Autonomic Research (2018) 28:355–362 https://doi.org/10.1007/s10286-018-0529-8

Scientific Contact
Prof. Dr. Walter Struhal
Department of Neurology
University Hospital Tulln
Karl Landsteiner University of Health Sciences
Dr.-Karl-Dorrek-Straße 30
3500 Krems / Austria
T +43 2272 9004 79750
E walter.struhal@tulln.lknoe.at
W http://www.kl.ac.at/

About Karl Landsteiner University of Health Sciences
Karl Landsteiner University of Health Sciences (KL) is a pioneer for innovation in medical and health sciences education and research, and a catalyst for groundbreaking work which will benefit society at large. Research at KL focuses on niche fields in bridge disciplines such as biomedical engineering, psychology and psychodynamics, as well as topics including water quality and related health issues. Study programmes include health sciences, human medicine, psychology, psychotherapy and counselling and have full European recognition. A network of university hospitals in St Poelten, Krems, and Tulln provides students with quality-assured, research-led education; it enables them to do top-class clinical research that is recognised worldwide. Karl Landsteiner University received accreditation by the Agency for Quality Assurance and Accreditation Austria (AQ Austria) in 2013.

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