Disease relevance of Hypotension, Orthostatic

• The mechanism of recumbent hypertension induced by fludrocortisone was studied in seven patients with orthostatic hypotension [1].
• Adverse effects were similar to those observed with levodopa and carbidopa, except that in individual patients abnormal involuntary movements and diurnal oscillations in performance (on-off effect) were decreased whereas orthostatic hypotension and mental changes were increased [2].
• Nortriptyline hydrochloride is an effective antidepressant that, in depressed patients without heart disease, causes significantly less orthostatic hypotension than imipramine [3].
• Treatment of idiopathic orthostatic hypotension (Shy-Drager syndrome) with indomethacin [4].
• Letter: Orthostatic hypotension, lactation, and breast cancer secondary to chlorpromazine administration [5].

Psychiatry related information on Hypotension, Orthostatic

• Other possible adverse effects--such as gastrointestinal disorders, orthostatic hypotension, levodopa-induced psychosis, sleep disturbances or parasomnias, or drug interactions--also require carefully monitored individual treatment [6].
• Dystonia, extrapyramidal syndrome, akathisia, and postural hypotension were not seen with ziprasidone [7].
• However, eight patients treated with clonidine were withdrawn from the trial due to hallucinations (two), seizures (two), symptomatic orthostatic hypotension (three) or drowsiness (one), indicating that clonidine is less effective than chlormethiazole in the prevention of the major manifestations of alcohol withdrawal [8].

High impact information on Hypotension, Orthostatic

• Treatment of orthostatic hypotension with erythropoietin [9].
• Fludrocortisone in orthostatic hypotension [10].
• Discrete brain areas and sympathetic ganglia obtained at autopsy from patients with idiopathic orthostatic hypotension were assayed for tyrosine hydroxylase and dopamine beta-hydroxylase [11].
• Efficacy of midodrine for neurogenic orthostatic hypotension [12].
• The introduction of additional agents of this class with properties different from prazosin provides slower onset of action, which should reduce the degree of first-dose and postural hypotension and a longer duration of action, which allows for once-a-day dosage [13].

Chemical compound and disease context of Hypotension, Orthostatic

• We determined the pressor effect of phenylpropanolamine hydrochloride, a widely used sympathomimetic agent, in 14 patients with autonomic failure and orthostatic hypotension [14].
• The increase in plasma norepinephrine concentrations in the patients with orthostatic hypotension was significantly lower (P less than 0.025) than in the patients without neuropathy, whereas plasma renin responses to standing were similar in the four groups [15].
• Tyramine and M.A.O. inhibitors in postural hypotension [16].
• Treatment of idiopathic orthostatic hypotension with xamoterol [17].
• Tyramine given orally with tranylcypromine produced a moderate rise in blood-pressure which was sustained for 2-4 hours, enabling patients to walk about without symptoms of orthostatic hypotension [18].

Biological context of Hypotension, Orthostatic

• In patients with orthostatic hypotension, increasing the red-cell volume with erythropoietin elevates blood pressure while standing [9].
• DL-dihydroxyphenylserine was given by mouth in a single-blind, placebo-controlled trial to two patients with orthostatic hypotension due to dopamine-beta-hydroxylase deficiency, in the hope of providing noradrenaline by endogenous decarboxylation [19].
• There have been few studies evaluating the long-term effectiveness of the combination of calcium blockers and nitrates, but available evidence suggests that symptoms of excessive vasodilation such as orthostatic hypotension may limit the usefulness of this approach [20].
• Plasma volume did not change after subcutaneous insulin in subjects with IDDM without autonomic neuropathy, whereas it decreased in those with autonomic neuropathy and orthostatic hypotension from 1.692 +/- 0.069 to 1.610 +/- 0.064 L/m2, without orthostatic hypotension from 1.631 +/- 0.027 to 1.593 +/- 0.024 L/m2, P < 0.05) [21].
• However, treatment sometimes becomes difficult given that certain categories of antihypertensive drugs interfere with blood glucose control and/or lipid metabolism, interfere with the symptomatology of hypoglycemia, or promote orthostatic hypotension, a complication of autonomic neuropathy [22].

Anatomical context of Hypotension, Orthostatic

• It is suggested that depletion of norepinephrine from nerve endings was responsible for autonomic dysfunction and orthostatic hypotension in these patients [23].
• At a dose of dipyridamole which was well below the MTD, one patient experienced symptomatic orthostatic hypotension, and another patient with coronary artery disease developed dizziness and transient electrocardiogram abnormalities [24].
• The therapeutic efficacy of midodrine, an alpha-adrenergic agonist that does not cross the blood-brain barrier, was investigated in a double-blind crossover trial in seven patients with orthostatic hypotension due to autonomic failure [25].
• Conversely, in patients with markedly impaired baroreceptor mechanisms, treatment with midodrine may produce extracellular fluid volume depletion and exacerbate orthostatic hypotension [25].
• Five patients with idiopathic orthostatic hypotension, two of whom had central nervous system manifestations (Shy-Drager syndrome), were treated with midodrine, an investigational alpha-adrenergic agonist, in a dosage of 2.5 to 5 mg three times daily [26].

Gene context of Hypotension, Orthostatic

• A transthyretin (TTR) mutation is described in a 44 year old French woman from Caen who presented at the age of 40 with neuropathy in all four extremities, diarrhoea, and orthostatic hypotension [27].
• Systolic orthostatic hypotension was observed in only one patient during the control test, but it occurred more frequently after L-Dopa/DDC inhibitor, regardless of concomitant administration of either entacapone (n = 3) or placebo (n = 4) [28].
• To test this hypothesis, we fine-mapped the NEDD4L region in 2 families with orthostatic hypotension, which we previously reported to be linked to human chromosome 18q21 but failed to implicate NEDD4L in these families [29].
• Post adrenalectomy, orthostatic hypotension persisted; a prolonged vasoconstrictive response to AVP was found in vitro in the patient's sc small arteries [30].
• METHODS: Fifteen Type 1 diabetic patients with serious complications (DM-COMP) were selected because of severe symptomatic autonomic neuropathy, including significant postural hypotension [31].

Analytical, diagnostic and therapeutic context of Hypotension, Orthostatic

• Efficacy of midodrine vs placebo in neurogenic orthostatic hypotension. A randomized, double-blind multicenter study. Midodrine Study Group [32].
• Four subjects with orthostatic hypotension were given intravenous infusions of methoxamine and isoproterenol [33].
• Long lasting, grade IV, orthostatic hypotension after a single cycle combination chemotherapy with paclitaxel and cisplatin [34].
• Acute oral administration of doses of losulazine ranging from 0.1 to 30 mg/kg did not cause orthostatic hypotension [35].
• Cardiovascular tests showed orthostatic hypotension below -30 mm Hg in 41%, low CV R-R below 1.5 in 57%, supine plasma NA below 100 pg/ml in 28%, and denervation supersensitivity of the vessels (alpha in 73%; beta2 in 60%) and of the heart (beta1 in 62%) [36].

References