J Korean Acad Rehabil Med.  2008 Feb;32(1):45-50.

The Effect of Midodrine on Exercise-induced Hypotension in Cervical Cord Injury Patients

• Jung H
• Seo JH
• Ko MH
• Park SH
• Sim YJ

Abstract

OBJECTIVE
To evaluate the effect of midodrine, an alpha(1) agonist, on symptom and hemodynamic response during standing and arm bicycle ergometer exercise in patients with cervical cord injury. METHOD: Twelve cervical spinal cord injury patients with orthostatic hypotension symptoms and post-exercise hypo- tension were enrolled. They were positioned on a 90degrees standing frame for 3 minutes. After 15 minutes of resting on supine position, 5 minutes of arm bicycle ergometer exercise was done. These tests were done without midodrine initially, but, with 5 mg midodrine on the next day. Heart rate, self-perceived presyncope score (PPS), systolic and diastolic blood pressure were measured before, during and after the exercise.
RESULTS
With 5 mg midodrine, the decrease of systolic and diastolic blood pressures after 3 minutes' standing was significantly smaller than without midodrine (p<0.05). PPS was also significantly decreased with midodrine on standing frame test. Arm ergometer exercise induced less systolic blood pressure decrease and better PPS on immediate and 5 minutes after exercise with midodrine (p<0.05). The change of diastolic blood pressure and heart rate was not significant after the exercise with midodrine.
CONCLUSION
In cervical spinal cord injury patients with orthostatic and post-exercise hypotension, 5 mg midodrine significantly improved the symptoms and the systolic blood pressures.

Keyword

Midodrine; Post-exercise hypotension; Cervical cord injury

MeSH Terms

Arm
Blood Pressure
Heart Rate
Hemodynamics
Humans
Hypotension
Hypotension, Orthostatic
Midodrine
Post-Exercise Hypotension
Spinal Cord Injuries
Supine Position
Syncope
Midodrine