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Water drinking as a treatment for orthostatic syndromesPURPOSE: Water drinking increases blood pressure in a substantial proportion of patients who have severe orthostatic hypotension due to autonomic failure. We tested the hypothesis that water drinking can be used as a practical treatment for patients with orthostatic and postprandial hypotension, as well as those with orthostatic tachycardia. SUBJECTS AND METHODS: We studied the effect of drinking water on seated and standing blood pressure and heart rate in 11 patients who had severe orthostatic hypotension due to autonomic failure and in 9 patients who had orthostatic tachycardia due to idiopathic orthostatic intolerance. We also tested the effect of water drinking on postprandial hypotension in 7 patients who had autonomic failure. Patients drank 480 mL of tap water at room temperature in less than 5 minutes. RESULTS: In patients with autonomic failure, mean (+/- SD) blood pressure after 1 minute of standing was 83 +/- 6/53 +/- 3.4 mm Hg at baseline, which increased to 114 +/- 30/66 +/- 18 mm Hg (P <0.01) 35 minutes after drinking. After a meal, blood pressure decreased by 43 +/- 36/20 +/- 13 mm Hg without water drinking, compared with 22 +/- 10/12 +/- 5 mm Hg with drinking (P <0.001). In patients with idiopathic orthostatic intolerance, water drinking attenuated orthostatic tachycardia (123 +/- 23 beats per minute) at baseline to 108 +/- 21 beats per minute after water drinking ( P <0.001). CONCLUSION: Water drinking elicits a rapid pressor response in patients with autonomic failure and can be used to treat orthostatic and postprandial hypotension. Water drinking moderately reduces orthostatic tachycardia in patients with idiopathic orthostatic intolerance. Thus, water drinking may serve as an adjunctive treatment in patients with impaired orthostatic tolerance.
Document ID
20040088407
Acquisition Source
Legacy CDMS
Document Type
Reprint (Version printed in journal)
Authors
Shannon, John R.
(Vanderbilt University Nashville, Tennessee, United States)
Diedrich, Andre
Biaggioni, Italo
Tank, Jens
Robertson, Rose Marie
Robertson, David
Jordan, Jens
Date Acquired
August 21, 2013
Publication Date
April 1, 2002
Publication Information
Publication: The American journal of medicine
Volume: 112
Issue: 5
ISSN: 0002-9343
Subject Category
Aerospace Medicine
Funding Number(s)
CONTRACT_GRANT: HL 56693
CONTRACT_GRANT: NS 33460
CONTRACT_GRANT: RR 00095
Distribution Limits
Public
Copyright
Other
Keywords
Non-NASA Center
NASA Discipline Regulatory Physiology
Clinical Trial

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