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Effects of daily water drinking on orthostatic and postprandial hypotension in patients with multiple system atrophy

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Abstract

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 (ΔBP) were assessed as an index of the effect of water drinking.

Results

Water drinking elicited a rapid pressor response in all patients. The ΔBP 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.

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Authors and Affiliations

  1. Dept. of Gastroenterology and Neurology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan

    Kazushi Deguchi, Kazuyo Ikeda, Mieko Shimamura, Yoshiteru Urai, Masago Tsukaguchi & Shigeki Kuriyama

  2. Dept. of Neurology, Kagawa Inoshita Hospital, 818-1 Hanaine, Onohara-cho, Kan-onji-shi, Kagawa, 769-1613, Japan

    Iwao Sasaki

  3. Dept. of Health Sciences, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan

    Tetsuo Touge

  4. Kaisei Hospital, 3-5-28 Muro-machi, Sakaide-shi, Kagawa, 762-0007, Japan

    Hiroaki Takeuchi

Authors
  1. Kazushi Deguchi
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  2. Kazuyo Ikeda
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  3. Iwao Sasaki
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  4. Mieko Shimamura
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  5. Yoshiteru Urai
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  6. Masago Tsukaguchi
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  7. Tetsuo Touge
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  8. Hiroaki Takeuchi
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  9. Shigeki Kuriyama
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Correspondence to Shigeki Kuriyama.

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Deguchi, K., Ikeda, K., Sasaki, I. et al. Effects of daily water drinking on orthostatic and postprandial hypotension in patients with multiple system atrophy. J Neurol 254, 735–740 (2007). https://doi.org/10.1007/s00415-006-0425-3

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  • DOI: https://doi.org/10.1007/s00415-006-0425-3

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