TREATMENT OF POSTPRANDIAL HYPOTENSION WITH SELECTIVE ALPHA(1), AND BETA(1) ADRENERGIC AGONISTS

In order to treat postprandial hypotension (PPH), we orally administer ed a combination of denopamine (10 mg, a selective beta(1)-adrenergic agonist) and midodrine-HCI (4 mg, a selective alpha(1)-adrenergic agon ist) to eight patients with autonomic failure (AF) prior to and after eating. When the patients were given 75 g glucose with 225 mr water wi thout drugs, blood pressure fell subsequently, cardiac output (CO) was unchanged, and vascular resistance of the lower legs (LVR) decreased. However, concomitant administration of denopamine and midodrine-HCl p revented PPH and increased CO and LVR. The portal blood flow was not i ndifferent to the drugs. A marked increase in heart rate after drug ad ministration was seen in some patients with AF, which reflects the sup ersensitivity to denopamine. Combined oral administration of denopamin e and midodrine-HCI is a safe and useful therapy for PPH in patients w ith AF.