Abstract | BACKGROUND: OBJECTIVE: DESIGN: RESULTS: No significant differences were seen in the supine BP, either systolic (P = .36) or diastolic (P = .85). In contrast, the primary end point of the fall in standing diastolic BP was significantly reduced (P = .02) with treatment. Pairwise comparison showed significant reduction by pyridostigmine alone (BP fall of 27.6 mm Hg vs 34.0 mm Hg with placebo; P = .04) and pyridostigmine and 5 mg of midodrine hydrochloride (BP fall of 27.2 mm Hg vs 34.0 mm Hg with placebo; P = .002). Standing BP improvement significantly regressed with improvement in OH symptoms. CONCLUSIONS:
Pyridostigmine significantly improves standing BP in patients with OH without worsening supine hypertension. The greatest effect is on diastolic BP, suggesting that the improvement is due to increased total peripheral resistance.
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Authors | Wolfgang Singer, Paola Sandroni, Tonette L Opfer-Gehrking, Guillermo A Suarez, Caroline M Klein, Stacy Hines, Peter C O'Brien, Jeffrey Slezak, Phillip A Low |
Journal | Archives of neurology
(Arch Neurol)
Vol. 63
Issue 4
Pg. 513-8
(Apr 2006)
ISSN: 0003-9942 [Print] United States |
PMID | 16476804
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
- Cholinesterase Inhibitors
- Vasoconstrictor Agents
- Midodrine
- Pyridostigmine Bromide
- Norepinephrine
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Topics |
- Adolescent
- Adult
- Arteries
(innervation, physiopathology)
- Autonomic Nervous System Diseases
(complications, drug therapy, physiopathology)
- Baroreflex
(drug effects, physiology)
- Cholinergic Fibers
(drug effects, metabolism)
- Cholinesterase Inhibitors
(pharmacology, therapeutic use)
- Cross-Over Studies
- Double-Blind Method
- Female
- Ganglia, Autonomic
(drug effects, metabolism, physiopathology)
- Ganglia, Sympathetic
(drug effects, metabolism, physiopathology)
- Humans
- Male
- Midodrine
(adverse effects)
- Neural Pathways
(drug effects, metabolism, physiopathology)
- Norepinephrine
(metabolism)
- Pyridostigmine Bromide
(pharmacology, therapeutic use)
- Regional Blood Flow
(drug effects, physiology)
- Shy-Drager Syndrome
(drug therapy, physiopathology)
- Treatment Outcome
- Vasoconstriction
(drug effects, physiology)
- Vasoconstrictor Agents
(adverse effects)
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