RESEARCH: Water drinking as a treatment for orthostatic syndromes.

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Am J Med 2002 Apr 1;112(5):355-60

Water drinking as a treatment for orthostatic syndromes.

JR, Diedrich A, Biaggioni I, Tank J, on RM, on D,

Jordan

J.

Blaser Shy-Drager Research Program (JRS, AD, IB, RMR, DR), Autonomic

Dysfunction Center, Vanderbilt University, Nashville, Tennessee, USA

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.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.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).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.

PMID: 11904109 [PubMed - in process]