Effect of High Dietary Sodium Intake in Patients With Postural Tachycardia Syndrome

Garland, Emily M.; Gamboa, Alfredo; Nwazue, Victor C.; Celedonio, Jorge E; Paranjape, Sachin Y.; Black, Bonnie K.; Okamoto, Luis E.; Shibao, Cyndya A.; Biaggioni, Italo; Robertson, David; Diedrich, André; Dupont, William D.; Raj, Satish R.

doi:10.1016/j.jacc.2021.03.005

Cited by 30 publications

(23 citation statements)

References 26 publications

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“…Standing norepinephrine was decreased (753 pg/mL, IQR 498-919 vs 959, IQR 736-1161, P = 0.017), but the change in norepinephrine from supine to standing did not reach statistical significance. Although not statistically significant, the high-salt diet was associated with a lower symptom burden on the Vanderbilt Orthostatic Symptoms Scale (P = 0.1) (Garland et al, 2021). Whether these results would be sustained over time if a high-salt diet were continued has not been tested.…”

Section: Oral Hydration For Orthostatic Intolerancementioning

confidence: 92%

Oral and intravenous hydration in the treatment of orthostatic hypotension and postural tachycardia syndrome

Snapper

Cheshire

2022

Autonomic Neuroscience

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Section: Oral Hydration For Orthostatic Intolerancementioning

confidence: 92%

Oral and intravenous hydration in the treatment of orthostatic hypotension and postural tachycardia syndrome

Snapper

Cheshire

2022

Autonomic Neuroscience

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“…The findings of a small 2005 case-control intervention study suggest that advising patients to drink 3 L of water per day and to maximize their dietary salt intake can promote sodium retention and blood volume expansion. 28 A small 2021 case-control crossover study found that high sodium intake leads to expanded plasma volume, and reduced upright norepinephrine levels and heart rate in patients with POTS, 41 although long-term data about sustained benefit and late adverse effects are still needed. Compression garments for the lower body can mitigate the gravity-induced fluid shifts that occur on standing, and decrease orthostatic tachycardia and standing tachycardia as shown in a 2021 randomized crossover study of lower body compression during tilt table testing in patients with POTS.…”

Section: Nonpharmacological Treatmentsmentioning

confidence: 99%

Diagnosis and management of postural orthostatic tachycardia syndrome

Raj

Fedorowski

Sheldon

2022

CMAJ

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Postural orthostatic tachycardia syndrome (POTS) is a chronic multisystem disorder; the cardinal feature is orthostatic tachycardia.• Patients with POTS have symptoms of orthostatic intolerance that improve with recumbence.• Girls and women are more commonly affected with POTS, beginning in puberty and through early adulthood.• Postural orthostatic tachycardia syndrome can lead to marked functional disability, often limiting work or schooling.• Treatments for POTS can improve symptoms and function, and can be initiated in primary care.

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“…Some individuals may be on a lowsalt diet as part of promoted lifestyle changes (such as to prevent hypertension), and salt repletion is needed especially with a low BP. Those with a low-salt appetite may need salt supplementation (Garland et al, 2021), the target being at least 6 g/day as recommended in the general population. These measures should be To also be considered…”

Section: Nonpharmacological Measuresmentioning

confidence: 99%

Dysautonomia in the Ehlers–Danlos syndromes and hypermobility spectrum disorders—With a focus on the postural tachycardia syndrome

Owens

Iodice

Hakim

2021

American J of Med Genetics Pt C

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Dysautonomia (autonomic dysfunction) occurs in the Ehlers-Danlos syndromes (EDS) and hypermobility spectrum disorders (HSD). Symptoms include palpitations, dizziness, presyncope, and syncope, especially when standing upright. Symptoms of orthostatic intolerance are usually relieved by sitting or lying and may be exacerbated by stimuli in daily life that cause vasodilatation, such as food ingestion, exertion, and heat. Neurocardiovascular dysautonomia may result in postural tachycardia syndrome (PoTS), a major cause of orthostatic intolerance. It is defined by a rise in heart rate of >30 beats per minute (bpm) in adults and >40 bpm in teenagers while upright, without a fall in blood pressure (BP; orthostatic hypotension). In some, it can be compounded by the presence of low BP. For many, there is delay in clinicians recognizing the nature of the symptoms, and recognizing EDS or HSD, leading to delays in treatment. The onset of PoTS may be linked to an event such as infection, trauma, surgery, or stress. Gastrointestinal and urinary bladder involvement may occur, along with thermoregulatory dysfunction. In some, the mast cell activation syndrome may be contributary, especially if it causes vasodilatation. This paper reviews neurocardiovascular dysautonomia with an emphasis on PoTS, its characteristics, associations, pathophysiology, investigation, and treatment.

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Effect of High Dietary Sodium Intake in Patients With Postural Tachycardia Syndrome

Cited by 30 publications

References 26 publications

Oral and intravenous hydration in the treatment of orthostatic hypotension and postural tachycardia syndrome

Oral and intravenous hydration in the treatment of orthostatic hypotension and postural tachycardia syndrome

Diagnosis and management of postural orthostatic tachycardia syndrome

Dysautonomia in the Ehlers–Danlos syndromes and hypermobility spectrum disorders—With a focus on the postural tachycardia syndrome

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