Key result
Sildenafil reduced nighttime supine systolic blood pressure from 182 to 138 mm Hg (P=0.012 vs placebo), and NO inhibition improved orthostatic tolerance to 56 degrees (P=0.014) in AF patients.
Why the study?
Does modulation of nitric oxide function affect supine hypertension and orthostatic hypotension in patients with autonomic failure?
Population
14 patients with autonomic failure, including a subset of 8 with supine hypertension, and healthy control…
Comparison
N-monomethyl-l-arginine infusion and Sildenafil… vs Placebo and healthy controls with…
Design
Other
Authors
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May support NO modulation for supine hypertension and orthostatic intolerance in autonomic failure; hypothesis-generating pending larger trials.
Does modulation of nitric oxide function affect supine hypertension and orthostatic hypotension in patients with autonomic failure?
Absolute Event Rate: 171% vs 512%
p-value: p=0.001
Patients with autonomic failure have increased nitric oxide function contributing to orthostatic hypotension, suggesting NO potentiation could treat supine hypertension while NO inhibition could improve orthostatic hypotension.
Gamboa et al. (2008) studied Autonomic failure (n=14). N(G)-monomethyl-l-arginine and sildenafil vs. Placebo and healthy controls was evaluated on Dose of N(G)-monomethyl-l-arginine needed to produce a similar increase in blood pressure (p=0.001). Sildenafil reduced nighttime supine systolic blood pressure from 182 to 138 mm Hg (P=0.012 vs placebo), and NO inhibition improved orthostatic tolerance to 56 degrees (P=0.014) in AF patients.
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