February 22, 2019International Journal of AngiologyOpen Access

(r)Alpha Lipoic Acid Is a Safe, Effective Pharmacologic Therapy of Chronic Orthostatic Hypotension Associated with Low Sympathetic Tone

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Why the study?

Current pharmacologic therapy for chronic orthostatic hypotension can cause or worsen hypertension and fluid retention, whereas (r)alpha lipoic acid avoids those complications and may assist management.

Does alpha lipoic acid improve sympathetic and blood pressure responses to standing in patients with chronic orthostatic hypotension and low sympathetic tone?

Population

109 patients with low sympathetic tone upon standing

Comparison

Oral (r)ALA or (r)ALA/(s)ALA mixture vs 20 control patients

Design

Cohort study

Follow-up

Mean follow-up of 2.28 years

Authors

GMGary L. MurrayDeutsches Herzzentrum München JCJoseph ColomboPhysiological Society

Discussion

Member takes

Implication

r-ALA may ease NOH symptoms without worsening hypertension; leaves open need for randomized confirmation before practice change.

Structured PICO

Does alpha lipoic acid improve sympathetic and blood pressure responses to standing in patients with chronic orthostatic hypotension and low sympathetic tone?

Population

109 patients with low sympathetic tone upon standing, including 29 with neurogenic orthostatic hypotension (NOH, change in standing BP ≥ -20/-10 mm Hg) and 60 with orthostatic intolerance (OI, change in standing systolic BP between -6 and -19 mm Hg), and 20 control patients.

Intervention

Alpha lipoic acid (ALA) orally: either 590 to 788 mg (r)ALA or 867 to 1,500 mg of a 50/50 mixture of (r)ALA and inactive (s)ALA.

Comparator

20 control patients (no specific treatment described).

Outcome

Improvement in symptoms of orthostatic dysfunction, including sympathetic and blood pressure responses to head-up postural change (standing).surrogate

Alpha lipoic acid appears to safely improve sympathetic tone and blood pressure responses to standing in patients with chronic orthostatic hypotension and orthostatic intolerance.

Cite This Study

Murray et al. (2019) studied this question.

synapsesocial.com/papers/6a7d4001560d7d74ed46cc1d https://doi.org/10.1055/s-0038-1676957

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(r)Alpha Lipoic Acid Is a Safe, Effective Pharmacologic Therapy of Chronic Orthostatic Hypotension Associated with Low Sympathetic Tone

Discussion

Member takes

Implication

Structured PICO

Cite This Study

(r)Alpha Lipoic Acid Is a Safe, Effective Pharmacologic Therapy of Chronic Orthostatic Hypotension Associated with Low Sympathetic Tone

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Also Consider

Also Consider