Midodrine hydrochloride is effective in the treatment of children with postural orthostatic tachycardia syndrome
Open accessAbstract
BACKGROUND: The study was carried out to examine the effect of selective α1 adrenoceptor agonist midodrine hydrochloride vs. β-adrenergic blockade metoprolol in the treatment of children with postural orthostatic tachycardia syndrome (POTS). METHODS AND RESULTS: Fifty-three children with POTS were divided into group I (midodrine hydrochloride plus conventional therapy), group II (metoprolol plus conventional therapy) and group III (conventional therapy). Standing test was conducted for all participants. The cure rate, improvement rate, effective rate and score of symptoms were compared among the 3 groups. A Kaplan-Meier survivorship curve was used to describe the proportion of symptom-free cases during a long term follow-up. The cure rate and effective rate at the end of short term follow-up in group I were significantly higher than those of group II and group III (68.42% vs. 42.11% vs. 20.00%, P<0.05; 89.47% vs. 57.89% vs. 53.33%, P<0.05). After treatment, the symptom score in group I was significantly lower than group II and group III, respectively (1.1±2.2 vs. 2.8±2.4 vs. 3.7±2.0, P<0.05), and it also had significant difference between group II and group III (P<0.05). The symptom recurrent rate in group I was significantly lower than that of group II and group III, respectively (P<0.05), but it did not differ between group II and group III (P>0.05). CONCLUSIONS: Midodrine hydrochloride is effective in the treatment of children with POTS.
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Two randomized clinical trials reported that midodrine improved either hemodynamic changes to orthostasis or clinical symptoms in patients with POTS.
“Two randomized clinical trials reported that midodrine improved either hemodynamic changes to orthostasis or clinical symptoms in patients with POTS.145,146”
Midodrine is one of the few pharmacological agents positively tested in placebo-controlled studies for orthostatic hypotension.
“One of the few pharmacological agents positively tested in placebo-controlled studies for orthostatic hypotension.”
From Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management (2019) · cites this paper as [92]
Midodrine is a direct alpha1-adrenoreceptor agonist.
“Direct a1-adrenoreceptor agonist.”
From Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management (2019) · cites this paper as [92]
Midodrine may be effective in POTS patients with the hypovolaemic subtype and a low-blood-pressure phenotype with pronounced orthostatic intolerance.
“It may be effective in 'hypovolaemic' subtype and low-BP phenotype with pronounced orthostatic intolerance.”
From Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management (2019) · cites this paper as [92]
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- Authors
- Chen, L., Wang, L., Sun, J., Qin, J., Tang, C., Jin, H., & Du, J.
- Affiliations
- Peking University First Hospital (CN)
- Peking University (CN)
- Jilin University (CN)
- Department of Pediatrics, Peking University First Hospital
- Venue
- Circulation Journal
- Publisher
- Japanese Circulation Society
- Published
- 2011
- Volume
- 75
- Issue
- 4
- Pages
- 927-931
- ISSN
- 1346-9843 (ISSN-L)
- 1347-4820
- OpenAlex
- W2043589636
- Cited by
- 83
- References
- 14
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 9 · 2023: 4 · 2022: 7 · 2021: 3 · 2020: 10 · 2019: 3 · 2018: 5 · 2017: 3 · 2016: 6 · 2015: 4 · 2014: 10 · 2013: 5 · 2012: 8
- FWCI
- 7.51
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (30821001)
- 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 › Neurology › Long-Term Effects of COVID-19
- Keywords
- midodrine, postural orthostatic tachycardia syndrome, children, metoprolol, alpha-1 adrenergic agonists, beta-adrenergic blockade, autonomic dysfunction, symptom recurrence, treatment efficacy
- MeSH terms
- Adolescent, Child, Female, Follow-Up Studies, Humans, Metoprolol, Midodrine, Survival Rate, Disease-Free Survival, Postural Orthostatic Tachycardia Syndrome, Adrenergic alpha-1 Receptor Agonists
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