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Cited by 227Cardiovascular Syncope and Autonomic DisordersHeart Rate Variability and Autonomic ControlCardiovascular and exercise physiology

Water drinking acutely improves orthostatic tolerance in healthy subjects

Schroeder, Christoph, Bush, Victoria E., Norcliffe, Lucy J., Luft, Friedrich C., Tank, Jens, Jordan, Jens, Hainsworth, Roger·2002·Circulation
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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  • Rapid ingestion of cool water is effective in combating orthostatic intolerance and postprandial hypotension.

    “Rapid ingestion of cool water is reported to be effective in combating orthostatic intolerance and postprandial hypotension. 311”

    From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [311]

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Authors
Schroeder, C., Bush, V. E., Norcliffe, L. J., Luft, F. C., Tank, J., Jordan, J., & Hainsworth, R.
Affiliations
University of Leeds (GB)
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2002-11-26
Volume
106
Issue
22
Pages
2806-2811
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/01.cir.0000038921.64575.d0
OpenAlex
W2152115999
Cited by
227
References
30
Citations by year
2026: 2 · 2025: 5 · 2024: 4 · 2023: 7 · 2022: 7 · 2021: 15 · 2020: 9 · 2019: 5 · 2018: 13 · 2017: 18 · 2016: 8 · 2015: 8 · 2014: 13 · 2013: 13 · 2012: 10
FWCI
10.16
Type
journal article
Language
en
Open access
closed
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
Keywords
water drinking, orthostatic tolerance, orthostatic hypotension, syncope, head-up tilt, lower body negative pressure, autonomic dysfunction, blood pressure, heart rate, stroke volume, systemic vascular resistance, cerebral autoregulation, brachial artery blood flow, middle cerebral artery
MeSH terms
Administration, Oral, Adult, Blood Flow Velocity, Blood Pressure, Brachial Artery, Cerebrovascular Circulation, Drinking, Female, Heart Rate, Hemodynamics, Humans, Hypotension, Orthostatic, Lower Body Negative Pressure, Male, Mineral Waters, Posture, Reference Values, Water, Baroreflex, Cross-Over Studies, Tilt-Table Test, Middle Cerebral Artery

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