Elsevier

Autonomic Neuroscience

Volume 222, December 2019, 102590
Autonomic Neuroscience

Blood pressure and orthostatic hypotension as measures of autonomic dysfunction in patients from the transthyretin amyloidosis outcomes survey (THAOS)

https://doi.org/10.1016/j.autneu.2019.102590Get rights and content
Under a Creative Commons license
open access

Highlights

  • Orthostatic hypotension (OH) is an early symptom in ATTR amyloidosis.

  • Significantly worse quality of life was observed in patients with OH at enrollment.

  • Progressive increase in orthostatic differences was observed in patients with OH.

  • Changes in blood pressure can be a useful measure in ATTR amyloidosis.

Abstract

Introduction

Autonomic dysfunction, an early symptom of transthyretin amyloidosis (ATTR amyloidosis), requires investigations not readily available in many clinics. Although monitoring of orthostatic hypotension (OH) will not be a substitute for more specialized tests, it can add important information about initiation of dysautonomia. The aim of this study was to investigate whether simple blood pressure (BP) monitoring may be a useful tool for evaluation of disease progression and an early sign of autonomic dysfunction.

Methods

BP and OH data were from subjects enrolled in the Transthyretin Amyloidosis Outcomes Survey (THAOS). Characteristics associated with changes in BP and orthostatic difference were identified by regression analyses.

Results

OH tended to be present relatively early in the course of disease and was more common at enrollment (11.7%) than either diarrhea (2.4%) or unintentional weight loss (3.1%). In subjects with OH at enrollment, progressive increase in systolic and diastolic orthostatic difference was observed. OH was also associated with significantly worse quality of life.

Discussion

BP variability is a useful tool for assessing disease onset and severity in ATTR amyloidosis, particularly in patients with OH.

Trial registration

ClinicalTrials.gov: NCT00628745.

Keywords

Amyloidosis
Autonomic neuropathy
Blood pressure
Orthostatic hypotension
Registry
Transthyretin amyloidosis

Cited by (0)

Some of the data included in this manuscript were previously presented at the XXIII World Congress of Neurology (WCN), September 16–21, 2017, Kyoto, Japan.