Assessment of Inspiratory Breathing Devices to Improve Orthostatic Tolerance in Neurogenic Orthostatic Hypotension
试验速览
- 阶段
- 不适用
- 状态
- 撤回
- 发起方
- 试验地点
- 2
- 主要终点
- Magnitude of drop in Systolic Blood Pressure during head-up tilt
研究概览
简要总结
The investigators will test whether breathing through an inspiratory resistance device will improve the ability to be upright and decrease blood pressure drops on standing in patients with orthostatic hypotension.
详细描述
Orthostatic hypotension is commonly described, especially in an elderly population. Using data from a national hospital inpatient database, Shibao et al. have reported that the annual hospitalization rate for orthostatic hypotension was 233 per 100000 among patients older than 75 years. Orthostatic hypotension is associated with an increased risk of falls, increased risk of coronary heart disease and mortality.
Orthostatic hypotension is defined as a fall in systolic blood pressure of at least 20 mmHg within 3 minutes upon standing 3. Patients with orthostatic hypotension commonly experience lightheadedness or syncope. In normal individuals, changes in posture do not results in significant changes in blood pressure due to physiological compensation for the gravity-mediated pooling of blood in the lower limbs with upright posture. Unfortunately, in patients with impairments of the autonomic nervous system, one or more of these adaptive mechanisms fail, and an orthostatic fall in blood pressure results.
In this pilot study, we will test the hypothesis that breathing through an inspiratory resistance device will improve orthostatic tolerance and reduce orthostatic hypotension in patients with neurogenic orthostatic hypotension.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Treatment
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 18 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Diagnosed with neurogenic orthostatic hypotension by the Vanderbilt Autonomic Dysfunction Center
- •Decrease in systolic blood pressure ≥ 20 mmHg with position change from supine to standing (10 minutes)
- •Evidence of reproducibility suggestive of non-reversible nervous system origin for the orthostatic hypotension
- •Age between 18-80 years
- •Male and female subjects are eligible
- •Able and willing to provide informed consent
排除标准
- •Overt cause for orthostatic hypotension (such as acute dehydration)
- •Inability to give, or withdrawal of, informed consent
- •Other factors which in the investigator's opinion would prevent the subject from completing the protocol
结局指标
主要结局
Magnitude of drop in Systolic Blood Pressure during head-up tilt
时间窗: 1 min
次要结局
- "Standing Time" tolerated with systolic blood pressure above 70 mmHg(10 min (max))
- Symptom rating(10 min (max))
- Hemodynamics (non-invasive)(10 min)
研究者
Alfredo Gamboa
Research Assistant Professor of Medicine
Vanderbilt University Medical Center