Risk factors for falls among older adults: a review of the literature.

/pdf/2018-esc-guidelines-for-the-diagnosis-and-management-of-2zcev0cq5l.pdf

2018 ESC Guidelines for the diagnosis and management of syncope.

https://www.heartrhythmjournal.com/article/S1547-5271(15)00328-8/pdf

2015 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Treatment of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia, and Vasovagal Syncope

2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society

Hypertension is common among patients with diabetes, with the prevalence depending on type and duration of diabetes, age, sex, race/ethnicity, BMI, history of glycemic control, and the presence of kidney disease, among other factors (1–3). Furthermore, hypertension is a strong risk factor for atherosclerotic cardiovascular disease (ASCVD), heart failure, and microvascular complications. ASCVD—defined as acute coronary syndrome, myocardial infarction (MI), angina, coronary or other arterial revascularization, stroke, transient ischemic attack, or peripheral arterial disease presumed to be of atherosclerotic origin—is the leading cause of morbidity and mortality for individuals with diabetes and is the largest contributor to the direct and indirect costs of diabetes. Numerous studies have shown that antihypertensive therapy reduces ASCVD events, heart failure, and microvascular complications in people with diabetes (4–8). Large benefits are seen when multiple risk factors are addressed simultaneously (9). There is evidence that ASCVD morbidity and mortality have decreased for people with diabetes since 1990 (10,11) likely due in large part to improvements in blood pressure control (12–14). This Position Statement is intended to update the assessment and treatment of hypertension among people with diabetes, including advances in care since the American Diabetes Association (ADA) last published a Position Statement on this topic in 2003 (3).

#### Recommendations

/pdf/diabetes-and-hypertension-a-position-statement-by-the-3v9umv1n04.pdf

Diabetes and Hypertension: A Position Statement by the American Diabetes Association

Roy Freeman • Wouter Wieling • Felicia B. Axelrod • David G. Benditt • Eduardo Benarroch • Italo Biaggioni • William P. Cheshire • Thomas Chelimsky • Pietro Cortelli • Christopher H. Gibbons • David S. Goldstein • Roger Hainsworth • Max J. Hilz • Giris Jacob • Horacio Kaufmann • Jens Jordan • Lewis A. Lipsitz • Benjamin D. Levine • Phillip A. Low • Christopher Mathias • Satish R. Raj • David Robertson • Paola Sandroni • Irwin Schatz • Ron Schondorff • Julian M. Stewart • J. Gert van Dijk

Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome.

Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome

Publisher Summary Familial dysautonomia (FD), also known as Riley–Day syndrome or hereditary sensory and autonomic neuropathy type III, is an autosomal recessive disease caused by mutations in the gene that encodes for I-κ-B kinase complex associated protein (IKAP). Typically, affected patients present at birth with hypotonia, episodic skin blotching and irritability. Infants do not respond to pain or cold stimuli. Oral incoordination and abnormal swallowing reflexes lead to feeding difficulties and recurrent bouts of aspiration pneumonia. Blood pressure instability occurs in all patients from birth. Cortical arousal results in hypertension and tachycardia. Patients with FD have blunted baroreceptor afferents and, as a consequence, their blood pressure is extremely labile. Although reduced in number, efferent sympathetic nerves are functional. Supine plasma norepinephrine levels are normal in FD. Stimuli that activate efferent sympathetic neurons, independently of baroreceptor afferent pathways, such as cognitive tasks and emotional arousal, dramatically increase blood pressure, heart rate and circulating norepinephrine levels. Pharmacologic treatment of the labile blood pressure in patients with FD is complex and frequently unsuccessful, because drugs that increase standing blood pressure worsen hypertension and drugs that lower blood pressure may worsen orthostatic hypotension.

Felicia B. Axelrod

Papers

Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome.

Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome

Familial Dysautonomia (Riley–Day Syndrome)