Skip to main content

Water Ingestion As Prophylaxis Against Syncope: Fact or Fancy?

  • Chapter
Cardiac Arrhythmias 2005
  • 652 Accesses

Conclusions

Water drinking elicits a profound pressor response in autonomic failure patients. It increases blood pressure to a lesser degree in tetraplegic patients, cardiac transplant recipients, and older healthy subjects. Blood pressure does not change in healthy young subjects. The haemodynamic response to water drinking appears to be mediated through sympathetic activation via an unknown mechanism. Water drinking improves orthostatic responses in patients with orthostatic hypotension and orthostatic tachycardia, and delays the onset of neurocardiogenic syncope in healthy subjects. Thus, water drinking may be a promising and essentially cost-free intervention for all these conditions, either as monotherapy or in conjunction with other non-pharmacological or pharmacological treatments.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

References

  1. Jordan J, Shannon JR, Grogan E et al (1999) A potent pressor response elicited by drinking water. Lancet 353:723

    Article  PubMed  CAS  Google Scholar 

  2. Jordan J, Shannon JR, Black BK et al (2000) The pressor response to water drinking in humans: a sympathetic reflex? Circulation 101:504–509

    PubMed  CAS  Google Scholar 

  3. Cariga P, Mathias CJ (2001) Haemodynamics of the pressor effect of oral water in human sympathetic denervation due to autonomic failure. Clin Sci (Lond) 101:313–319

    Article  PubMed  CAS  Google Scholar 

  4. Mathias CJ (2000) A 21st century water cure. Lancet 356:1046–1048

    Article  PubMed  CAS  Google Scholar 

  5. Routledge HC, Chowdhary S, Coote JH et al (2002) Cardiac vagal response to water ingestion in normal human subjects. Clin Sci (Lond) 103:157–162

    Article  PubMed  Google Scholar 

  6. Tank J, Schroeder C, Stoffels M et al (2003) Pressor effect of water drinking in tetraplegic patients may be a spinal reflex. Hypertension 41:1234–1239

    Article  PubMed  CAS  Google Scholar 

  7. Scott EM, Greenwood JP, Gilbey SG et al (2001) Water ingestion increases sympathetic vasoconstrictor discharge in normal human subjects. Clin Sci Colch 100:335–342

    Article  PubMed  CAS  Google Scholar 

  8. Schroeder C, Bush VE, Norcliffe LJ et al (2002) Water drinking acutely improves orthostatic tolerance in healthy subjects. Circulation 106:2806–2811

    Article  PubMed  Google Scholar 

  9. Ebert TJ, Smith JJ, Barney JA et al (1986) The use of thoracic impedance for determining thoracic blood volume changes in man. Aviat Space Environ Med 57:49–53

    PubMed  CAS  Google Scholar 

  10. Shannon JR, Jordan J, Diedrich A et al (2000) Sympathetically mediated hypertension in autonomic failure. Circulation 101:2710–2715

    PubMed  CAS  Google Scholar 

  11. Biaggioni I, Robertson RM, Robertson D (1994) Manipulation of norepinephrine metabolism with yohimbine in the treatment of autonomic failure. J Clin Pharmacol 34:418–423

    PubMed  CAS  Google Scholar 

  12. Jordan J, Shannon JR, Biaggioni I et al (1998) Contrasting actions of pressor agents in severe autonomic failure. Am J Med 105:116–124

    Article  PubMed  CAS  Google Scholar 

  13. Robertson D, Goldberg MR, Tung CS et al (1986) Use of alpha 2 adrenoreceptor agonists and antagonists in the functional assessment of the sympathetic nervous system. J Clin Invest 78:576–581

    Article  PubMed  CAS  Google Scholar 

  14. Hoffman WE, Phillips MI, Wilson E et al (1977) A pressor response associated with drinking in rats. Proc Soc Exp Biol Med 154:121–124

    PubMed  CAS  Google Scholar 

  15. Geelen G, Greenleaf JE, Keil LC (1996) Drinking-induced plasma vasopressin and norepinephrine changes in dehydrated humans. J Clin Endocrinol Metab 81:2131–2135

    Article  PubMed  CAS  Google Scholar 

  16. Jordan J, Tank J, Shannon JR et al (2002) Baroreflex buffering and susceptibility to vasoactive drugs. Circulation 105:1459–1464

    Article  PubMed  CAS  Google Scholar 

  17. Robertson D, Hollister AS, Carey EL et al (1984) Increased vascular beta2-adrenoreceptor responsiveness in autonomic dysfunction. J Am Coll Cardiol 3:850–856

    Article  PubMed  CAS  Google Scholar 

  18. Boschmann M, Steiniger J, Hille U et al (2003) Water-induced thermogenesis. J Clin Endocrinol Metab 88:6015–1619

    Article  PubMed  CAS  Google Scholar 

  19. Benarroch EE, Schmeichel AM, Parisi JE (2000) Involvement of the ventrolateral medulla in parkinsonism with autonomic failure. Neurology 54:963–968

    PubMed  CAS  Google Scholar 

  20. Goldstein DS, Polinsky RJ, Garty M et al (1989) Patterns of plasma levels of catechols in neurogenic orthostatic hypotension. Ann Neurol 26:558–563

    Article  PubMed  CAS  Google Scholar 

  21. Goldstein DS, Holmes C, Cannon RO et al (1997) Sympathetic cardioneuropathy in dysautonomias. N Engl J Med 336:696–702

    Article  PubMed  CAS  Google Scholar 

  22. Rossi P, Andriesse GI, Oey PL et al (1998) Stomach distension increases efferent muscle sympathetic nerve activity and blood pressure in healthy humans. J Neurol Sci 161:148–155

    Article  PubMed  CAS  Google Scholar 

  23. Ploutz-Snyder L, Foley J, Ploutz-Snyder R et al (1999) Gastric gas and fluid emptying assessed by magnetic resonance imaging. Eur J Appl Physiol Occup Physiol 79:212–220

    Article  PubMed  CAS  Google Scholar 

  24. Haberich FJ (1968) Osmoreception in the portal circulation. Fed Proc 27:1137–1141

    PubMed  CAS  Google Scholar 

  25. Lipp A, Tank J, Franke G et al (2005) Osmosensitive mechanisms contribute to the water drinking-induced, sympathetically-mediated, pressor response in humans. Neurology (in press)

    Google Scholar 

  26. Adachi A (1984) Thermosensitive and osmoreceptive afferent fibers in the hepatic branch of the vagus nerve. J Auton Nerv Syst 10:269–273

    Article  PubMed  CAS  Google Scholar 

  27. Shannon JR, Diedrich A, Biaggioni I et al (2002) Water drinking as a treatment for orthostatic syndromes. Am J Med 355–360

    Google Scholar 

  28. Streeten DH, Anderson GJ, Richardson R et al (1988) Abnormal orthostatic changes in blood pressure and heart rate in subjects with intact sympathetic nervous function: evidence for excessive venous pooling. J Lab Clin Med 111:326–335

    PubMed  CAS  Google Scholar 

  29. Jacob G, Shannon JR, Black B et al (1997) Effects of volume loading and pressor agents in idiopathic orthostatic tachycardia. Circulation 96:575–580

    PubMed  CAS  Google Scholar 

  30. Low PA, Schondorf R, Novak V et al (1997) Postural orthostatic tachycardia syndrome. In: Low PA (ed) Clinical Autonomic Disorders. Lippincott-Raven, Philadelphia, pp 681–697

    Google Scholar 

  31. Jordan J, Shannon JR, Black BK et al (1998) Raised cerebrovascular resistance in idiopathic orthostatic intolerance: evidence for sympathetic vasoconstriction. Hypertension 32:699–704

    PubMed  CAS  Google Scholar 

  32. Lu CC, Diedrich A, Tung CS et al (2003) Water ingestion as prophylaxis against syncope. Circulation 108:2660–2665

    Article  PubMed  Google Scholar 

  33. Thijs RD, Reijntjes RH, van Dijk JG (2003) Water drinking as a potential treatment for idiopathic exercise-related syncope: a case report. Clin Auton Res 13:103–105

    Article  PubMed  Google Scholar 

  34. Jordan J, Shannon JR, Diedrich A et al (2004) Water potentiates the pressor effect of ephedra alkaloids. Circulation 109:1823–1825

    Article  PubMed  CAS  Google Scholar 

  35. Shannon JR, Jordan J, Costa F et al (1997) The hypertension of autonomic failure and its treatment. Hypertension 30:1062–1067

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Springer-Verlag Italia

About this chapter

Cite this chapter

Jordan, J. (2006). Water Ingestion As Prophylaxis Against Syncope: Fact or Fancy?. In: Raviele, A. (eds) Cardiac Arrhythmias 2005. Springer, Milano. https://doi.org/10.1007/88-470-0371-7_82

Download citation

  • DOI: https://doi.org/10.1007/88-470-0371-7_82

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0370-5

  • Online ISBN: 978-88-470-0371-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics