Treatment of Supine Hypertension in Autonomic Failure With Continuous Positive Airway Pressure
Vanderbilt University Medical Center
Summary
Supine hypertension is a common problem that affects at least 50% of patients with primary autonomic failure. Supine hypertension can be severe and complicates the treatment of orthostatic hypotension. The purpose of this study is to assess whether continuous positive airway pressure (CPAP) decreases blood pressure in autonomic failure patients with supine hypertension.
Description
Supine hypertension is a common problem that affects at least 50% of patients with primary autonomic failure. Supine hypertension can be severe and complicates the treatment of orthostatic hypotension. Drugs used for the treatment of orthostatic hypotension (eg, fludrocortisone and pressor agents), worsen supine hypertension. High blood pressure may also cause target organ damage in this group of patients. The pathophysiologic mechanisms causing supine hypertension in patients with autonomic failure have not been defined. This study will test the hypothesis that continuous positive airway pre…
Eligibility
- Age range
- 18–85 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Patients with autonomic failure and with supine hypertension from all races Exclusion Criteria: * All medical students * Pregnant women * High-risk patients (e.g. heart failure, symptomatic coronary artery disease, liver impairment, history of stroke or myocardial infarction) * History of serious allergies or asthma.
Interventions
- Devicecontinuous positive airway pressure (CPAP)
Continuous positive airway pressure(CPAP) will be applied during the night starting from 20:00. CPAP level will be determined during an acute CPAP trial.
- DrugPlacebo
Placebo pill or patch. Single dose
Location
- Autonomic Dysfunction Center/ Vanderbilt University Medical CenterNashville, Tennessee