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Midodrine in neurogenic orthostatic hypotension. A new treatment.
Int Angiol. 1993 Jun; 12(2):125-31.IA

Abstract

Neurogenic orthostatic hypotension is a severely disabling condition due to deficient peripheral vasoconstrictor tone in response to the upright position and is characterized by a decrease in blood pressure upon standing associated with symptoms of lightheadedness, dizziness, visual "white-out", weakness, lack of energy, near syncope or even syncope. Previous pharmacologic treatment of neurogenic orthostatic hypotension has been problematic. Midodrine, a new specific alpha-1-agonist has been shown to produce arteriolar constriction and decrease in venous pooling via a constriction of venous capacitance vessels. Therefore, a recent multicenter study evaluated the safety and efficacy of midodrine therapy in 97 patients with neurogenic orthostatic hypotension due to various etiologies: Shy Drager syndrome (No. 18); Bradbury Eggleston syndrome (idiopathic orthostatic hypotension) (No. 20); diabetic autonomic neuropathy (No. 27); Parkinson's disease (No. 22); and miscellaneous (No. 10). Following one week of placebo therapy, the patients were randomized into 4 groups for a 4 week period of time; placebo, 2.5 mg, 5 mg, or 10 mg three times daily. The BE/SDS subgroup demonstrated a 27 +/- 8% (22 mmHg) increase in standing systolic blood pressure for the 10 mg dose. Diabetics achieved a significant increase at 5 mg. Similar increases were observed for the entire group on the 10 mg dose (p < 0.001). Symptoms or fainting, blurred vision, improved energy level, standing time, and depressed feelings were also significantly improved even at lower doses (p < 0.05 or less). Side effects were mild. Therefore, midodrine is an effective and safe agent for the treatment of neurogenic orthostatic hypotension.

Authors+Show Affiliations

Department of Medicine, Chicago Medical School, Illinois.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Review

Language

eng

PubMed ID

7690383

Citation

Gilden, J L.. "Midodrine in Neurogenic Orthostatic Hypotension. a New Treatment." International Angiology : a Journal of the International Union of Angiology, vol. 12, no. 2, 1993, pp. 125-31.
Gilden JL. Midodrine in neurogenic orthostatic hypotension. A new treatment. Int Angiol. 1993;12(2):125-31.
Gilden, J. L. (1993). Midodrine in neurogenic orthostatic hypotension. A new treatment. International Angiology : a Journal of the International Union of Angiology, 12(2), 125-31.
Gilden JL. Midodrine in Neurogenic Orthostatic Hypotension. a New Treatment. Int Angiol. 1993;12(2):125-31. PubMed PMID: 7690383.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Midodrine in neurogenic orthostatic hypotension. A new treatment. A1 - Gilden,J L, PY - 1993/6/1/pubmed PY - 1993/6/1/medline PY - 1993/6/1/entrez SP - 125 EP - 31 JF - International angiology : a journal of the International Union of Angiology JO - Int Angiol VL - 12 IS - 2 N2 - Neurogenic orthostatic hypotension is a severely disabling condition due to deficient peripheral vasoconstrictor tone in response to the upright position and is characterized by a decrease in blood pressure upon standing associated with symptoms of lightheadedness, dizziness, visual "white-out", weakness, lack of energy, near syncope or even syncope. Previous pharmacologic treatment of neurogenic orthostatic hypotension has been problematic. Midodrine, a new specific alpha-1-agonist has been shown to produce arteriolar constriction and decrease in venous pooling via a constriction of venous capacitance vessels. Therefore, a recent multicenter study evaluated the safety and efficacy of midodrine therapy in 97 patients with neurogenic orthostatic hypotension due to various etiologies: Shy Drager syndrome (No. 18); Bradbury Eggleston syndrome (idiopathic orthostatic hypotension) (No. 20); diabetic autonomic neuropathy (No. 27); Parkinson's disease (No. 22); and miscellaneous (No. 10). Following one week of placebo therapy, the patients were randomized into 4 groups for a 4 week period of time; placebo, 2.5 mg, 5 mg, or 10 mg three times daily. The BE/SDS subgroup demonstrated a 27 +/- 8% (22 mmHg) increase in standing systolic blood pressure for the 10 mg dose. Diabetics achieved a significant increase at 5 mg. Similar increases were observed for the entire group on the 10 mg dose (p < 0.001). Symptoms or fainting, blurred vision, improved energy level, standing time, and depressed feelings were also significantly improved even at lower doses (p < 0.05 or less). Side effects were mild. Therefore, midodrine is an effective and safe agent for the treatment of neurogenic orthostatic hypotension. SN - 0392-9590 UR - https://www.unboundmedicine.com/medline/citation/7690383/Midodrine_in_neurogenic_orthostatic_hypotension__A_new_treatment_ L2 - https://www.lens.org/lens/search/patent/list?q=citation_id:7690383 DB - PRIME DP - Unbound Medicine ER -