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[Title & authors         ]
Clinical Trial
Circulation
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. 2002 Nov 26;106(22):2806-11.
doi: 10.1161/01.cir.0000038921.64575.d0.

Water drinking acutely improves orthostatic tolerance in healthy
subjects

Christoph Schroeder^  1 , Victoria E Bush, Lucy J Norcliffe, 
Friedrich C Luft, Jens Tank, Jens Jordan, Roger Hainsworth
Affiliations Expand

Affiliation

  * ^1 Franz-Volhard Clinical Research Center, Medical Faculty of the
    Charite, Humboldt-University, Berlin, Germany.

  * PMID: 12451007
  * DOI: 10.1161/01.cir.0000038921.64575.d0

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Clinical Trial

Water drinking acutely improves orthostatic tolerance in healthy
subjects

Christoph Schroeder et al. Circulation. 2002.
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Circulation
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. 2002 Nov 26;106(22):2806-11.
doi: 10.1161/01.cir.0000038921.64575.d0.

Authors

Christoph Schroeder^  1 , Victoria E Bush, Lucy J Norcliffe, 
Friedrich C Luft, Jens Tank, Jens Jordan, Roger Hainsworth

Affiliation

  * ^1 Franz-Volhard Clinical Research Center, Medical Faculty of the
    Charite, Humboldt-University, Berlin, Germany.

  * PMID: 12451007
  * DOI: 10.1161/01.cir.0000038921.64575.d0

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Abstract

Background: Orthostatic symptoms and syncope are common, even in
apparently healthy subjects. In patients with severe autonomic
dysfunction, water drinking elicits an acute pressor response and
improves orthostatic hypotension. We tested the hypothesis that water
drinking also improves orthostatic tolerance in healthy subjects.

Methods and results: In a randomized, controlled, crossover fashion,
13 healthy subjects (9 men, 4 women, 31+/-2 years) ingested 500 mL
and 50 mL of mineral water 15 minutes before head-up tilt on two
separate days. Finger blood pressure, brachial blood pressure, heart
rate, thoracic impedance, and blood flow velocity in the brachial
artery and the middle cerebral artery were measured. Orthostatic
tolerance was determined as the time to presyncope during a combined
protocol of 20 minutes of 60 degrees head-up tilt alone, followed by
additional increasing steps of lower body negative pressure (-20,
-40, and -60 mm Hg for 10 minutes each or until presyncope). Drinking
500 mL of water improved orthostatic tolerance by 5+/-1 minute
(range, -1 to +11 minutes, P<0.001). After drinking 500 mL of water,
supine mean blood pressure increased slightly (P<0.01) as the result
of increased peripheral resistance (P<0.01). It also blunted both the
increase in heart rate and the decrease in stroke volume with head-up
tilt. Cerebral blood flow regulation improved after water drinking.

Conclusions: Water drinking elicits an acute hemodynamic response and
changes in cerebrovascular regulation in healthy subjects. These
effects are associated with a marked improvement in orthostatic
tolerance.

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