Temporary elimination of orthostatic hypotension by norepinephrine infusion
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.
KeywordsNorepinephrine Orthostatic hypotension Sympathetic nervous system Baroreflex
The research reported here was supported by the Division of Intramural Research of the National Institute of Neurological Disorders and Stroke.
Conflict of interest
The authors have no conflicts of interest to disclose.
- 6.Lehmann M, Petersen KG, Khalaf AN, Haussinger D, Buchner C, Sellinger M, Peter K (1990) Improvement of the exercise capacity of a patient with primary orthostatic hypotension (primary sympathetic insufficiency) by programmed subcutaneous noradrenaline administration via microdosing pump. Klin Wochenschr 68:873PubMedCrossRefGoogle Scholar