BloodPressure

Two randomised controlled trials (RCTs) (n=171 and n=97) found that midodrine significantly increased standing blood pressure 1 hour post‑dose compared with placebo in people with symptomatic orthostatic hypotension due to autonomic dysfunction. There was also limited evidence that midodrine improved some symptoms of orthostatic hypotension, such as syncope (fainting) and low energy levels. However, results for other symptoms such as light‑headedness and dizziness were less positive, and the studies did not assess quality of life, falls or ability to carry out daily activities.  

There is limited evidence from 2 small short-term studies that fludrocortisone improves postural blood pressure and orthostatic symptoms. In another slightly larger study fludrocortisone had no effect on supine blood pressure or wellbeing in a population with chronic fatigue syndrome.  

Illustrated tutorial overview of the Renin-Angiotensin-Aldosterone System.  

Dr Clyde Yancy leads a panel discussion on the practice implications of the SPRINT findings suggesting a more stringent blood pressure target with Drs Bittner, Curtis, and O'Gara.  

Dr Goldhaber discusses some changes we may see in the incidence of MI, stroke, DVT, and PE if the medical community were to accept and adopt the new blood pressure targets studied in SPRINT.