ICYMI: Midodrine Increases PAH Therapy Tolerability


From May 13-18, 2022, the American Thoracic Society (ATS) held its Annual Meeting, where researchers and stakeholders discussed research, patient care, and public health trends within the fields of pulmonary and sleep disorders, as well as critical illness. According to Pulmonology Advisor, one presentation during the meeting centered around the use of midodrine in pulmonary arterial hypertension (PAH) treatment. In Abstract P184, researchers discussed how midodrine could help patients better tolerate their therapies. 

About Midodrine

The Mayo Clinic explains that midodrine is often used to treat orthostatic hypotension (low blood pressure when standing). The treatment works by:

stimulating nerve endings in blood vessels, causing the blood vessels to tighten. As a result, blood pressure is increased.

Treating PAH can actually cause orthostatic hypotension. This is due to the medications used. However, no prior research had ever considered whether midodrine could help relieve symptoms of hypotension in those with PAH, allowing them to continue on their necessary medications for a more sustained period of time. 

So, within this study, researchers wanted to understand whether midodrine could be an effective therapeutic option to address low blood pressure in those with PAH. Altogether, researchers sourced data from 132 individuals with PAH. Of these, seven individuals – all female – had severe hypotension which was inhibiting their treatment efficacy. 

Midodrine treatment ranged from 2.5-10mg one to three times daily. One patient experienced such impressive improvements that she no longer needed to be treated with midodrine or for PAH. The remaining patients saw heightened arterial pressure and a reduction in hypotension symptoms. 

What is Pulmonary Arterial Hypertension (PAH)? 

Pulmonary arterial hypertension (PAH) is a chronic, progressive form of high blood pressure in the lungs. Any pulmonary arterial pressure over 25 mm Hg at rest is considered to be PAH. This high blood pressure causes the narrowing, thickening, hardening, or blocking of pulmonary arteries. As a result, less oxygen-rich blood is circulated throughout the body, and the heart muscle can be weakened. Typically, PAH occurs 2x more in females than males. PAH can be caused by BMPR2 gene mutations, drug use, HIV, sickle cell disease, congenital heart disease, autoimmune diseases, lung diseases, and liver disease, among others. Symptoms can include fatigue, swelling of the lower extremities, shortness of breath which worsens during exertion, dizziness, and chest pain.

Jessica Lynn

Jessica Lynn

Jessica Lynn has an educational background in writing and marketing. She firmly believes in the power of writing in amplifying voices, and looks forward to doing so for the rare disease community.

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