The treatment of postprandial hypotension in autonomic failure with 3,4-DL-threo-dihydroxyphenylserine.
Postprandial hypotension occurs commonly in patients with autonomic failure and may be due to attenuation of the normal sympathetic nervous system activation in response to meal ingestion. In a randomized, double-blind, placebo-controlled study, we investigated the therapeutic effect of the norepinephrine precursor 3,4-DL-threo-dihydroxyphenylserine (DL-DOPS) on this condition. We measured blood pressure, heart rate, forearm vascular resistance, and plasma DL-DOPS and norepinephrine in 11 patients with autonomic failure. DL-DOPS attenuated the postprandial fall in blood pressure. This was associated with an increase in plasma norepinephrine and forearm vascular resistance. DL-DOPS therapy did not change the postprandial increase in heart rate. There was a trend toward increased supine hypertension associated with DL-DOPS treatment. This study shows that DL-DOPS is a promising treatment for postprandial hypotension and provides support for the hypothesis that postprandial hypotension is, at least in part, due to decreased activation of the sympathetic nervous system.
Freeman
R
R
Department of Neurology, Beth Israel Deaconess Medical Center, Hebrew Rehabilitation Center for the Aged, Boston, MA, USA.
Young
J
J
Landsberg
L
L
Lipsitz
L
L
D000328:Adult; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000150:complications*; D001794:Blood Pressure / Q000187:drug effects; D015103:Droxidopa / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007022:Hypotension / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
D015103:Droxidopa