Key result
Ganglionic blockade with trimethaphan decreased systolic blood pressure by 17+/-1.6 mm Hg in patients with idiopathic orthostatic intolerance compared to 3.9+/-3.8 mm Hg in control subjects (P<0.01).
Why the study?
Does ganglionic blockade with trimethaphan reveal differences in sympathetic activation between patients with idiopathic orthostatic intolerance and control subjects?
Population
Patients with idiopathic orthostatic intolerance (OI) (at least n=14 based on subgroups) and control subjects.
Comparison
Incremental bolus doses of isoproterenol and… vs Control subjects receiving the same…
Design
Case-control
Authors
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Suggests heightened beta-adrenergic sensitivity in OI; hypothesis-generating and requires validation before clinical use.
Case-Control
Does ganglionic blockade with trimethaphan reveal differences in sympathetic activation between patients with idiopathic orthostatic intolerance and control subjects?
Absolute Event Rate: 17% vs 3.9%
p-value: p=<0.01
The hyperadrenergic features of idiopathic orthostatic intolerance appear to originate from enhanced sympathetic activation rather than systemic hypersensitivity of postsynaptic adrenoreceptors.
Jordan et al. (2002) conducted a case-control in Idiopathic orthostatic intolerance. Ganglionic blockade with trimethaphan vs. Control subjects was evaluated on Decrease in systolic blood pressure with trimethaphan (p=<0.01). Ganglionic blockade with trimethaphan decreased systolic blood pressure by 17+/-1.6 mm Hg in patients with idiopathic orthostatic intolerance compared to 3.9+/-3.8 mm Hg in control subjects (P<0.01).
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