This Article Full Text Full Text (PDF) All Versions of this Article: 106/22/2806    most recent 01.CIR.0000038921.64575.D0v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Schroeder, C. Articles by Hainsworth, R. Search for Related Content PubMed PubMed Citation Articles by Schroeder, C. Articles by Hainsworth, R. Related Collections Autonomic, reflex, and neurohumoral control of circulation Other Treatment Other diagnostic testing

(Circulation. 2002;106:2806.)
© 2002 American Heart Association, Inc.

Clinical Investigation and Reports

Water Drinking Acutely Improves Orthostatic Tolerance in Healthy Subjects

Christoph Schroeder, MD^*; Victoria E. Bush, PhD^*; Lucy J. Norcliffe, BSc^*; Friedrich C. Luft, MD; Jens Tank, MD; Jens Jordan, MD; Roger Hainsworth, MB, PhD, DSc

From Franz-Volhard Clinical Research Center, Medical Faculty of the Charité, Humboldt-University, Berlin, Germany (C.S., F.C.L., J.T., J.J.); and the Institute of Cardiovascular Research, University of Leeds, Leeds, United Kingdom (V.E.B., L.J.N., R.H.).

Correspondence to Jens Jordan, MD, Clinical Research Center, Haus 129, Franz-Volhard-Clinic, Humboldt University, Wiltbergstr 50, 13125 Berlin, Germany. E-mail jordan{at}fvk-berlin.de

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° 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.

Key Words: hemodynamics • vasodilation • syncope • cerebrovascular disorders

This article has been cited by other articles:

				R. Carter III, S. N. Cheuvront, C. R. Vernieuw, and M. N. Sawka Hypohydration and prior heat stress exacerbates decreases in cerebral blood flow velocity during standing J Appl Physiol, December 1, 2006; 101(6): 1744 - 1750. [Abstract] [Full Text] [PDF]

				C. T. P. Krediet, J. J. van Lieshout, L. W. J. Bogert, R. V. Immink, Y.-S. Kim, and W. Wieling Leg crossing improves orthostatic tolerance in healthy subjects: a placebo-controlled crossover study Am J Physiol Heart Circ Physiol, October 1, 2006; 291(4): H1768 - H1772. [Abstract] [Full Text] [PDF]

				C. M. Brown, L. Barberini, A. G. Dulloo, and J.-P. Montani Cardiovascular responses to water drinking: does osmolality play a role? Am J Physiol Regulatory Integrative Comp Physiol, December 1, 2005; 289(6): R1687 - R1692. [Abstract] [Full Text] [PDF]

				Y.-I. Kamijo, T. Okumoto, Y. Takeno, K. Okazaki, M. Inaki, S. Masuki, and H. Nose Transient cutaneous vasodilatation and hypotension after drinking in dehydrated and exercising men J. Physiol., October 15, 2005; 568(2): 689 - 698. [Abstract] [Full Text] [PDF]

				A. Lipp, J. Tank, G. Franke, G. Arnold, F. C. Luft, and J. Jordan Osmosensitive mechanisms contribute to the water drinking-induced pressor response in humans Neurology, September 27, 2005; 65(6): 905 - 907. [Abstract] [Full Text] [PDF]

				V. E. Claydon, L. J. Norcliffe, J. P. Moore, M. Rivera, F. Leon-Velarde, O. Appenzeller, and R. Hainsworth Cardiovascular responses to orthostatic stress in healthy altitude dwellers, and altitude residents with chronic mountain sickness Exp Physiol, January 1, 2005; 90(1): 103 - 110. [Abstract] [Full Text] [PDF]

				V. E. Claydon, L. J. Norcliffe, J. P. Moore, M. Rivera-Ch, F. Leon-Velarde, O. Appenzeller, and R. Hainsworth Orthostatic tolerance and blood volumes in Andean high altitude dwellers Exp Physiol, September 1, 2004; 89(5): 565 - 571. [Abstract] [Full Text] [PDF]

				V. E. Claydon and R. Hainsworth Salt Supplementation Improves Orthostatic Cerebral and Peripheral Vascular Control in Patients With Syncope Hypertension, April 1, 2004; 43(4): 809 - 813. [Abstract] [Full Text] [PDF]

				M. Boschmann, J. Steiniger, U. Hille, J. Tank, F. Adams, A. M. Sharma, S. Klaus, F. C. Luft, and J. Jordan Water-Induced Thermogenesis J. Clin. Endocrinol. Metab., December 1, 2003; 88(12): 6015 - 6019. [Abstract] [Full Text] [PDF]

				C.-C. Lu, A. Diedrich, C.-S. Tung, S. Y. Paranjape, P. A. Harris, D. W. Byrne, J. Jordan, and D. Robertson Water Ingestion as Prophylaxis Against Syncope Circulation, November 25, 2003; 108(21): 2660 - 2665. [Abstract] [Full Text] [PDF]

				J. Tank, C. Schroeder, M. Stoffels, A. Diedrich, A. M. Sharma, F. C. Luft, and J. Jordan Pressor Effect of Water Drinking in Tetraplegic Patients May Be a Spinal Reflex Hypertension, June 1, 2003; 41(6): 1234 - 1239. [Abstract] [Full Text] [PDF]