Orthostatic responses to nitric oxide synthase inhibition in persons with tetraplegia.

To determine the effects of 1.0 mg/kg nitro-L-arginine methyl ester (L-NAME) on orthostatic mean arterial pressure (MAP), serum aldosterone, and plasma renin concentrations in persons with chronic tetraplegia compared with nonspinal cord-injured controls.
Prospective placebo-controlled intervention study.
James J. Peters Veterans Affairs Medical Center.
Patients (n=5) with tetraplegia and controls (n=7) participated. The groups were matched for age, height, and weight; the average duration of injury in the tetraplegia group was 22+/-14 years.
Subjects with tetraplegia visited the laboratory twice, receiving placebo on day 1 and L-NAME (1.0 mg/kg) on day 2. The agents were infused via an intravenous catheter over 60 minutes with the patient in the supine position. Data were collected during the infusion and then during head-up tilt to 45 degrees for 30 minutes. Control subjects visited the laboratory once for placebo infusion and the head-up tilt maneuver.
Orthostatic MAP.
Orthostatic MAP was reduced after placebo infusion in subjects with tetraplegia compared with controls (69+/-11 vs 89+/-9 mmHg, respectively; P<.01) and compared with L-NAME infusion (90+/-16 mmHg; P<.01). Orthostatic MAP did not differ when comparing the tetraplegia group with controls after L-NAME infusion. Orthostatic aldosterone levels were increased after placebo compared with L-NAME infusion in persons with tetraplegia; plasma renin levels did not differ among the groups.
These data suggest that nitric oxide synthase inhibition may have clinical potential for treatment of orthostatic hypotension in persons with chronic tetraplegia.
AuthorsJill M Wecht, Miroslav Radulovic, Michael F Lafountaine, Dwindally Rosado-Rivera, Run-Lin Zhang, William A Bauman
JournalArchives of physical medicine and rehabilitation (Arch Phys Med Rehabil) Vol. 90 Issue 8 Pg. 1428-34 (Aug 2009) ISSN: 1532-821X [Electronic] United States
PMID19651280 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)
Chemical References
  • Placebos
  • Nitric Oxide Synthase
  • NG-Nitroarginine Methyl Ester
  • Adult
  • Analysis of Variance
  • Blood Pressure (drug effects)
  • Case-Control Studies
  • Female
  • Heart Rate (drug effects)
  • Humans
  • Hypotension, Orthostatic (drug therapy)
  • Male
  • Middle Aged
  • NG-Nitroarginine Methyl Ester (pharmacology)
  • Nitric Oxide Synthase (antagonists & inhibitors)
  • Placebos
  • Prospective Studies
  • Quadriplegia (enzymology)
  • Spinal Cord Injuries (drug therapy)
  • Tilt-Table Test

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research network!

Choose Username:
Verify Password: