Effective Remedy for Blood Pressure Drop When Standing Up

One-third were able to stop taking any other orthostatic hypotension medications, and others were able to lower the amount of other drugs needed. Mayo Clinic neurologists have discovered a drug application smart enough to alleviate orthostatic hypotension — problems with sinking blood pressure when standing up from a sitting position — without the unwanted effect of also causing patients’ blood pressure to soar when lying down.

“This is a significant step forward for these patients,” says Phillip Low, M.D., Mayo Clinic neurologist and lead study investigator. “This would be a good drug to provide the first line of treatment.”

The drug, pyridostigmine, (Mestinon® 60mgm) has been used for years for myasthenia gravis, a neuromuscular transmission disorder. Dr. Low hypothesized that it would also improve nerve cell transmission for orthostatic hypotension patients and trigger the reflex that controls blood pressure in all positions.
Of the 58 patients in Dr. Low’s study, one-third were able to stop taking any other orthostatic hypotension medications, and others were able to lower the amount of other drugs needed.

Orthostatic hypotension is especially common in those over age 70. In general, blood pressure control lessens as one ages, according to Dr. Low. Common causes of orthostatic hypotension include diabetes, autonomic neuropathy, multiple system atrophy, pure autonomic failure and Parkinson’s disease. Certain drugs, such as diuretics and medication used to control blood pressure, are also common catalysts for the condition.