Orthostatic Hypotension post Bariatric Surgery. Other intraoperative and postprocedural complications and disorders of the circulatory system, not elsewhere classified
Conditions
Interventions
Intervention 1: Intervention group: Patients will receive midodrine 2.5 mg three times daily, in addition to therapeutic recommendations including increased fluid and salt intake, use of compression s
Sponsors
Shiraz University of Medical Sciences
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Inclusion criteria
Inclusion criteria: Age 18–65 years Underwent bariatric surgery (e.g., sleeve gastrectomy, gastric bypass, etc.) at least 4 weeks prior to study enrollment and up to 5 years post-surgery Diagnosis of orthostatic hypotension (OH) according to the following criteria:=20 mmHg drop in systolic blood pressure or =10 mmHg drop in diastolic blood pressure within 3 minutes of standing No use of midodrine or similar medications in the past 2 weeks No severe cardiovascular diseases that, according to physician assessment, contraindicate the use of midodrine
Exclusion criteria
Exclusion criteria: Intolerance to midodrine or occurrence of severe adverse effects during the study Severe renal failure (GFR < 30 ml/min) Uncontrolled diabetes or autonomic neuropathy History of neurological diseases or primary autonomic disorders (e.g., Parkinson’s disease) Use of antihypertensive medications that have a direct effect on orthostatic hypotension Inability or unwillingness of the patient to comply with follow-up
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Improvement of systolic/diastolic blood pressure and symptom in standing position after 1 month of treatment with midodrine. Timepoint: Day 0: Measurement of blood pressure, assessment of orthostatic hypotension symptoms, and evaluation of patient quality of life.Day 7: Measurement of blood pressure, assessment of symptoms, and monitoring of adverse events.Day 14: Measurement of blood pressure, evaluation of treatment efficacy, and monitoring of adverse events.1 Month: Assessment of persistence of drug effects, monitoring of potential adverse events, and decision regarding continuation of therapy. Method of measurement: Supine Position: The patient remains in a supine position for at least 5 minutes, after which blood pressure and heart rate are measured and recorded.Immediately after Standing: The patient changes from supine to standing, and blood pressure and heart rate are measured during the first minute of standing.3 Minutes after Standing: While remaining in the standing position, blood pressure is measured again at the third minute.5 Minutes after Standing (optional): In some studies, blood pressure is also recorded at the fifth minute of standing. | — |
Countries
Iran (Islamic Republic of)
Contacts
Public ContactHamed Bazrafshan Drissi
Shiraz University of Medical Sciences
Outcome results
None listed