Spinal Cord, 2020 · DOI: 10.1038/s41393-020-0448-0 · Published: September 1, 2020
This study investigates whether midodrine, a medication, can help increase blood pressure in people with spinal cord injuries (SCI) who experience low blood pressure, especially during cognitive tasks. The researchers also wanted to see if midodrine could improve blood flow to the brain and overall cognitive function in these individuals. The study found that while midodrine did increase blood pressure on average, the effect varied greatly among participants, and it didn't consistently normalize blood pressure or improve cognitive function.
Given the heterogeneity of response to midodrine, careful monitoring of patients following administration is crucial, and dosage adjustments may be necessary.
Future studies should explore higher or more frequent lower doses of midodrine, and investigate the effects on supine blood pressure and during autonomic dysreflexia.
Clinical management of hypotension in SCI should prioritize stabilizing as well as normalizing blood pressure, and consider alternative or combinatorial therapies.