Effects of daily water drinking on orthostatic and postprandial hypotension in patients with multiple system atrophy.
OBJECTIVE
It has been demonstrated that the increased blood pressure (BP) caused by a single dose of water alleviates orthostatic hypotension (OH) and postprandial hypotension (PPH) in patients with autonomic failure (AF). The aim of this study was to evaluate the practical effect of daily water drinking on OH and PPH in the morning when patients with AF are usually most affected.


METHODS
In five patients with multiple system atrophy (MSA) characterized by intractable OH and PPH, we measured seated, standing and postprandial BP in the morning without and with ingestion of 350 ml tap water at 07.30 hours for seven successive days. The changes from the basal BP level at 07.30 hours (DeltaBP) were assessed as an index of the effect of water drinking.


RESULTS
Water drinking elicited a rapid pressor response in all patients. The DeltaBP during sitting, standing and after a meal following water drinking (day 1 and day 7) was significantly higher than without water drinking (day 0). The effects of reducing OH and PPH on day 7 were equivalent to those on day 1. No adverse effects associated with daily water drinking were observed, except later diuresis, which occurred in one patient.


CONCLUSIONS
Daily water drinking demonstrated constant pressor effects in the morning with no severe adverse effects in MSA patients. This finding suggests that water drinking should be tried as a practical measure to prevent or reduce OH and PPH.
Deguchi
Kazushi
K
Dept. of Gastroenterology and Neurology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Kita-gun, Kagawa, 761-0793, Japan.
Ikeda
Kazuyo
K
Sasaki
Iwao
I
Shimamura
Mieko
M
Urai
Yoshiteru
Y
Tsukaguchi
Masago
M
Touge
Tetsuo
T
Takeuchi
Hiroaki
H
Kuriyama
Shigeki
S
D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology*; D002940:Circadian Rhythm / Q000502:physiology; D004326:Drinking / Q000502:physiology*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000150:complications*; D010507:Periodicity; D010953:Plasma Volume / Q000502:physiology; D019518:Postprandial Period / Q000502:physiology; D011187:Posture / Q000502:physiology; D011311:Pressoreceptors / Q000503:physiopathology; D012791:Shy-Drager Syndrome / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D013575:Syncope / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome; D014867:Water / Q000008:administration & dosage*
D014867:Water