Document Detail

Water drinking as a treatment for orthostatic syndromes.
MedLine Citation:
PMID:  11904109     Owner:  NLM     Status:  MEDLINE    
PURPOSE: 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.
John R Shannon; Andre Diedrich; Italo Biaggioni; Jens Tank; Rose Marie Robertson; David Robertson; Jens Jordan
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of medicine     Volume:  112     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-03-20     Completed Date:  2002-04-02     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  355-60     Citation Subset:  AIM; IM; S    
Nathan Blaser Shy-Drager Research Program, Autonomic Dysfunction Center, Vanderbilt University, Nashville, Tennessee, USA.
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MeSH Terms
Aged, 80 and over
Autonomic Nervous System Diseases / therapy*
Blood Pressure*
Heart Rate
Hypotension, Orthostatic / therapy*
Middle Aged
Grant Support
D Robertson / Vanderbilt U, Nashville, TN
Comment In:
Am J Med. 2002 Apr 1;112(5):419-21   [PMID:  11904120 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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