title: Temporary elimination of orthostatic hypotension by norepinephrine infusion.
abstract: A cardinal manifestation of chronic autonomic failure is neurogenic orthostatic hypotension (OH), which often is associated with supine hypertension, posing a therapeutic dilemma. We report here success in a first step toward development of a "prosthetic baroreceptor system" to maintain blood pressure during orthostasis without worsening supine hypertension. In all of four patients with neurogenic OH, titrated i.v. NE infusion kept directly recorded intra-arterial pressure at or above baseline during progressive head-up tilt. We conclude that titrated i.v. NE infusion temporarily eliminates OH.
authors.affiliation: Clinical Neurocardiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892-1620, USA. goldsteind@ninds.nih.gov
authors.forename: David S
authors.initials: DS
authors.lastname: Goldstein
authors.forename: LaToya
authors.initials: L
authors.lastname: Sewell
authors.forename: Courtney
authors.initials: C
authors.lastname: Holmes
authors.forename: Sandra
authors.initials: S
authors.lastname: Pechnik
authors.forename: André
authors.initials: A
authors.lastname: Diedrich
authors.forename: David
authors.initials: D
authors.lastname: Robertson
mesh_terms: D001794:Blood Pressure / Q000187:drug effects; D006801:Humans; D007024:Hypotension, Orthostatic / Q000188:drug therapy* / Q000209:etiology; D007261:Infusions, Intra-Arterial; D009638:Norepinephrine / Q000627:therapeutic use*; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy; D054970:Pure Autonomic Failure / Q000150:complications* / Q000188:drug therapy; D018667:Tilt-Table Test; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
chemical_list: D014662:Vasoconstrictor Agents; D009638:Norepinephrine