Abstract
Since indomethacin may be effective in the treatment of orthostatic hypotension, the ability of this drug to increase reflex vasoconstriction was studied in six patients with orthostatic hypotension and in five normal subjects. Reflex forearm vasoconstriction during lower body negative pressure at 20-40 mm Hg was measured before and after indomethacin 50 mg by mouth. In patients with orthostatic hypotension and central nervous system involvement indomethacin increased recumbent blood pressure, resting forearm vascular resistance, and reflex forearm vasoconstriction during lower body negative pressure. The fall in blood pressure with lower body negative pressure was not significantly inhibited by indomethacin, but mean blood pressure during lower body negative pressure was higher after than before indomethacin. Indomethacin did not alter these responses in normal subjects. The increase in reflex vasoconstriction with indomethacin may contribute to its therapeutic effects in the treatment of orthostatic hypotension.
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Selected References
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- Abate G., Polimeni R. M., Cuccurullo F., Puddu P., Lenzi S. Effects of indomethacin on postural hypotension in Parkinsonism. Br Med J. 1979 Dec 8;2(6203):1466–1468. doi: 10.1136/bmj.2.6203.1466. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brody M. J., Kadowitz P. J. Prostaglandins as modulators of the autonomic nervous system. Fed Proc. 1974 Jan;33(1):48–60. [PubMed] [Google Scholar]
- Crook J. E., Robertson D., Whorton A. R. Prostaglandin suppression: inability to correct severe idiopathic orthostatic hypotension. South Med J. 1981 Mar;74(3):318–320. [PubMed] [Google Scholar]
- Davies I. B., Bannister R., Sever P. S. Indomethacin treatment of postural hypotension in autonomic failure. Br Med J. 1980 Jan 19;280(6208):181–181. doi: 10.1136/bmj.280.6208.181-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hedqvist P. Actions of prostacyclin (PGI2) on adrenergic neuroeffector transmission in the rabbit kidney. Prostaglandins. 1979 Feb;17(2):249–258. doi: 10.1016/0090-6980(79)90045-5. [DOI] [PubMed] [Google Scholar]
- Kochar M. S., Itskovitz H. D. Treatment of idiopathic orthostatic hypotension (Shy-Drager syndrome) with indomethacin. Lancet. 1978 May 13;1(8072):1011–1014. doi: 10.1016/s0140-6736(78)90737-7. [DOI] [PubMed] [Google Scholar]
- Kontos H. A., Richardson D. W., Norvell J. E. Mechanisms of circulatory dysfunction in orthostatic hypotension. Trans Am Clin Climatol Assoc. 1976;87:26–35. [PMC free article] [PubMed] [Google Scholar]
- Malik K. U., Ryan P., McGiff J. C. Modification by prostaglandins E1 and E2, indomethacin, and arachidonic acid of the vasoconstrictor responses of the isolated perfused rabbit and rat mesenteric arteries to adrenergic stimuli. Circ Res. 1976 Aug;39(2):163–168. doi: 10.1161/01.res.39.2.163. [DOI] [PubMed] [Google Scholar]
- Myers H. A., Honig C. R. Influence of initial resistance on magnitude of response to vasomotor stimuli. Am J Physiol. 1969 Jun;216(6):1429–1436. doi: 10.1152/ajplegacy.1969.216.6.1429. [DOI] [PubMed] [Google Scholar]
- Streeten D. H., Kerr C. B., Kerr L. P., Prior J. C., Dalakos T. G. Hyperbradykininism: a new orthostatic syndrome. Lancet. 1972 Nov 18;2(7786):1048–1053. doi: 10.1016/s0140-6736(72)92337-9. [DOI] [PubMed] [Google Scholar]
- WHITNEY R. J. The measurement of volume changes in human limbs. J Physiol. 1953 Jul;121(1):1–27. doi: 10.1113/jphysiol.1953.sp004926. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ziegler M. G., Lake C. R., Kopin I. J. The sympathetic-nervous-system defect in primary orthostatic hypotension. N Engl J Med. 1977 Feb 10;296(6):293–297. doi: 10.1056/NEJM197702102960601. [DOI] [PubMed] [Google Scholar]