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Postprandial hypotension occurs commonly in patients with automatic failure and may due to attenuation of the normal sympathetic nervous system activation in response to meal ingestion.In a randomized,double- blind,placebo-controlled study,we investigated the therapeutic effect of the norepinephrine precursor 3,4-DL-threodihydroxyphenylserine(DL-DOPS)on this condition.We measured blood pressure,heart rate,forearm vascular resistance,and plasma DL-DOPS and norepinephrine in 11 patients with autonomic failure.DL-DOPS attenuated the postprandial fall in blood pressure.This was associated with an increase in heart rate.There was a trend toward increased supine hypertension associated with DL-DOPS treatment.This study shows that DL-DOPS is a promising treatment for postprandial hypotension and provides support for the hypothesis that postprandial hypotension is,at least in part,due to decreased activation of the sympathetic nervous system. |
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