Efficacy of Midodrine in patients with Parkinson’s Disease and Orthostatic Hypotension

Boven, M. van (Marjolein) (2014) Efficacy of Midodrine in patients with Parkinson’s Disease and Orthostatic Hypotension. thesis, Medicine.

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Abstract

Introduction: Orthostatic hypotension is defined as a fall of 20 mmHg systolic blood pressure (SBP) or 10 mmHg diastolic blood pressure (DBP) after standing for at least 3 minutes or an head-up tilt of at least 60 degrees. In Parkinson’s disease, hypotension is caused by a diminished sympathetic vasoconstrictor outflow, resulting in vasodilatation. Due to the lack of specific evaluation of antihypotensive pharmaceutics, including midodrine, in patients suffering from Parkinson’s disease related orthostatic hypotension no specific therapeutic strategy can be recommended. Patients and Methods: This retrospective study included 13 Parkinson’s disease patients with orthostatic hypotension, treated with midodrine. Patient data was obtained by retrieval of patient records and nursing files. The objectives of this analysis were to determine the efficacy of midodrine in Parkinson’s disease patients with orthostatic hypotension, including accompanying symptoms, like dizziness, fainting and falling. Also the adverse effects of midodrine were analyzed. Results: Midodrine increased standing systolic blood pressure (SBP) as well as standing diastolic blood pressure (DBP), together with a decreased standing heart rate (HR), whereas little changes of these parameters were seen in supine position. Midodrine decreased the accompanying symptoms related to orthostatic hypotension, existing of dizziness, fainting and falling. Overall the 15 mg dose of midodrine was more effective as compared to the 7.5 mg dose. The main only reported adverse event was supine hypertension (147/92 and 168/82) in 15% (2/13) of cases. Conclusion: Midodrine is clinically effective, showing increased standing blood pressure, together with an improvement of the clinical symptoms related to orthostatic hypotension, without significant increase of supine blood pressure.

Item Type:	Thesis (Thesis)
Supervisor name:	Laar, Dr. T. van and UMC Groningen, Martini Ziekenhuis
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:00
Last Modified:	25 Jun 2020 11:00
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2007

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