Abstract
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.
Keywords
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Article info
Publication history
Accepted:
December 5,
2002
Received in revised form:
November 27,
2001
Received:
May 9,
2001
Footnotes
☆Supported in part by National Institutes of Health Grants RR00095, HL56693, and NS33460; NASA Grant NAS 9-19483; and a grant from the Nathan Blaser Shy-Drager Research Program. Dr. Jordan is supported by the Deutsche Forschungsgemeinschaft.
Identification
Copyright
© 2001 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
