Prognosis
The goal of treatment is to improve symptoms and quality of life, and to prevent falls and morbidities associated with orthostatic hypotension (OH). It is important to treat symptoms rather than blood pressure levels.[29][39]
Neurodegenerative disorders with autonomic failure and a movement disorder
OH in patients with neurodegenerative disorders that affect autonomic nerves and motor pathways (e.g., Parkinson disease, multiple system atrophy) can be successfully treated with significant improvement in quality of life. However, the relentless progression of nonautonomic neurologic deficits is the main factor affecting prognosis.
Pure autonomic failure
Pure autonomic failure is a neurodegenerative disorder that does not affect motor pathways. The prognosis is usually benign if OH and other autonomic problems can be successfully treated. However, patients with pure autonomic failure have a 10% per year cumulative risk of developing Parkinson disease, dementia with Lewy bodies, or multiple system atrophy. This risk is increased in patients with REM sleep behavior disorder.[2][34]
Peripheral autonomic neuropathies
OH can be successfully treated in most autonomic neuropathies, but the prognosis depends on the underlying disorder.
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