Evidence map›Paper›PMID 27271310›Full record

Trial reportHypertension (Dallas, Tex. : 1979)2016

Efficacy of Servo-Controlled Splanchnic Venous Compression in the Treatment of Orthostatic Hypotension: A Randomized Comparison With Midodrine.

Luis E Okamoto, André Diedrich, Franz J Baudenbacher, René Harder, Jonathan S Whitfield, Fahad Iqbal, Alfredo Gamboa, Cyndya A Shibao, Bonnie K Black, Satish R Raj and 2 more

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Hypertension (Dallas, Tex. : 1979), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00223691 (Evaluation and Treatment of Autonomic Failure.), which is not on this map. Cited by 42 papers.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed
6.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00223691 phase1completednot on this map

Evaluation and Treatment of Autonomic Failure.

TypeinterventionalSponsorVanderbilt UniversityRan2002 to 2017Enrolled389ConditionsAutonomic Failure, Orthostatic HypotensionArmsAtomoxetine, Acarbose, Pyridostigmine Bromide, Yohimbine, Midodrine HCl
3 · Its place in the literature

Who cites it

42 citing papers in PubMed, 76 citations in OpenAlex.

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  6. How to treat cardiovascular autonomic failure in Parkinson's disease.Journal of neural transmission (Vienna, Austria : 1996) · 2026
    Review
  7. Review
  8. Observational
  9. Review
  10. Review
  11. Update on the Treatment of Autonomic Disorders.Current treatment options in neurology · 2025
    Article
  12. Article
  13. Approaches for treating cardiovascular symptoms in Parkinson's disease.Therapeutic advances in neurological disorders · 2025
    Review
  14. Cold Pressor Test Induces Significant Changes in Internal Jugular Vein Flow Dynamics in Healthy Young Adults.Medical science monitor : international medical journal of experimental and clinical research · 2024
    Article
  15. Article
  16. Review
  17. Review
  18. Engaging patients in the management of orthostatic intolerance.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2023
    Review
  19. Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Luis E OkamotoFrom the Vanderbilt Autonomic Dysfunction Center (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Division of Clinical Pharmacology (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Departments of Medicine (L.E.O., A.D., J.S.W., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Pharmacology (S.R.R., D.R., I.B.), Neurology (D.R.), Biomedical Engineering (A.D., F.J.B., F.I.), and Electrical Engineering (R.H.), Vanderbilt University School of Medicine, Nashville, TN.
André DiedrichFrom the Vanderbilt Autonomic Dysfunction Center (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Division of Clinical Pharmacology (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Departments of Medicine (L.E.O., A.D., J.S.W., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Pharmacology (S.R.R., D.R., I.B.), Neurology (D.R.), Biomedical Engineering (A.D., F.J.B., F.I.), and Electrical Engineering (R.H.), Vanderbilt University School of Medicine, Nashville, TN.
Franz J BaudenbacherFrom the Vanderbilt Autonomic Dysfunction Center (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Division of Clinical Pharmacology (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Departments of Medicine (L.E.O., A.D., J.S.W., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Pharmacology (S.R.R., D.R., I.B.), Neurology (D.R.), Biomedical Engineering (A.D., F.J.B., F.I.), and Electrical Engineering (R.H.), Vanderbilt University School of Medicine, Nashville, TN.
René HarderFrom the Vanderbilt Autonomic Dysfunction Center (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Division of Clinical Pharmacology (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Departments of Medicine (L.E.O., A.D., J.S.W., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Pharmacology (S.R.R., D.R., I.B.), Neurology (D.R.), Biomedical Engineering (A.D., F.J.B., F.I.), and Electrical Engineering (R.H.), Vanderbilt University School of Medicine, Nashville, TN.
Jonathan S WhitfieldFrom the Vanderbilt Autonomic Dysfunction Center (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Division of Clinical Pharmacology (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Departments of Medicine (L.E.O., A.D., J.S.W., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Pharmacology (S.R.R., D.R., I.B.), Neurology (D.R.), Biomedical Engineering (A.D., F.J.B., F.I.), and Electrical Engineering (R.H.), Vanderbilt University School of Medicine, Nashville, TN.
Fahad IqbalFrom the Vanderbilt Autonomic Dysfunction Center (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Division of Clinical Pharmacology (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Departments of Medicine (L.E.O., A.D., J.S.W., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Pharmacology (S.R.R., D.R., I.B.), Neurology (D.R.), Biomedical Engineering (A.D., F.J.B., F.I.), and Electrical Engineering (R.H.), Vanderbilt University School of Medicine, Nashville, TN.
Alfredo GamboaFrom the Vanderbilt Autonomic Dysfunction Center (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Division of Clinical Pharmacology (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Departments of Medicine (L.E.O., A.D., J.S.W., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Pharmacology (S.R.R., D.R., I.B.), Neurology (D.R.), Biomedical Engineering (A.D., F.J.B., F.I.), and Electrical Engineering (R.H.), Vanderbilt University School of Medicine, Nashville, TN.
Cyndya A ShibaoFrom the Vanderbilt Autonomic Dysfunction Center (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Division of Clinical Pharmacology (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Departments of Medicine (L.E.O., A.D., J.S.W., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Pharmacology (S.R.R., D.R., I.B.), Neurology (D.R.), Biomedical Engineering (A.D., F.J.B., F.I.), and Electrical Engineering (R.H.), Vanderbilt University School of Medicine, Nashville, TN.
Bonnie K BlackFrom the Vanderbilt Autonomic Dysfunction Center (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Division of Clinical Pharmacology (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Departments of Medicine (L.E.O., A.D., J.S.W., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Pharmacology (S.R.R., D.R., I.B.), Neurology (D.R.), Biomedical Engineering (A.D., F.J.B., F.I.), and Electrical Engineering (R.H.), Vanderbilt University School of Medicine, Nashville, TN.
Satish R RajFrom the Vanderbilt Autonomic Dysfunction Center (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Division of Clinical Pharmacology (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Departments of Medicine (L.E.O., A.D., J.S.W., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Pharmacology (S.R.R., D.R., I.B.), Neurology (D.R.), Biomedical Engineering (A.D., F.J.B., F.I.), and Electrical Engineering (R.H.), Vanderbilt University School of Medicine, Nashville, TN.
David RobertsonFrom the Vanderbilt Autonomic Dysfunction Center (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Division of Clinical Pharmacology (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Departments of Medicine (L.E.O., A.D., J.S.W., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Pharmacology (S.R.R., D.R., I.B.), Neurology (D.R.), Biomedical Engineering (A.D., F.J.B., F.I.), and Electrical Engineering (R.H.), Vanderbilt University School of Medicine, Nashville, TN.
Italo BiaggioniFrom the Vanderbilt Autonomic Dysfunction Center (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Division of Clinical Pharmacology (L.E.O., A.D., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Departments of Medicine (L.E.O., A.D., J.S.W., A.G., C.A.S., B.K.B., S.R.R., D.R., I.B.), Pharmacology (S.R.R., D.R., I.B.), Neurology (D.R.), Biomedical Engineering (A.D., F.J.B., F.I.), and Electrical Engineering (R.H.), Vanderbilt University School of Medicine, Nashville, TN. Italo.biaggioni@vanderbilt.edu.
Anna Needs Neuroblastoma Answers · US

Funding

The Vanderbilt Institute for Clinical and Translational Research (VICTR)UL1TR000445 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BERNARD, GORDON RAPHAEL · 2012 to 2016
$41.4M
Structural genomics of norepinephrine transportersP01HL056693 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ROBERTSON, DAVID HERLIE · 1997 to 2016
$30.8M
Training CoreU54NS065736 · NINDS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI KAUFMANN, HORACIO · 2009 to 2018
$11.6M
Splanchnic Circulation and Blood Pressure RegulationR01HL122847 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BIAGGIONI, ITALO · 2015 to 2018
$1.6M
NCATS NIH HHS UL1 TR000445NHLBI NIH HHS P01 HL056693NHLBI NIH HHS R01 HL122847NINDS NIH HHS U54 NS065736
6 · The paper itself

Abstract

unlabelledSplanchnic venous pooling is a major hemodynamic determinant of orthostatic hypotension, but is not specifically targeted by pressor agents, the mainstay of treatment. We developed an automated inflatable abdominal binder that provides sustained servo-controlled venous compression (40 mm Hg) and can be activated only on standing. We tested the efficacy of this device against placebo and compared it to midodrine in 19 autonomic failure patients randomized to receive either placebo, midodrine (2.5-10 mg), or placebo combined with binder on separate days in a single-blind, crossover study. Systolic blood pressure (SBP) was measured seated and standing before and 1-hour post medication; the binder was inflated immediately before standing. Only midodrine increased seated SBP (31±5 versus 9±4 placebo and 7±5 binder, P=0.003), whereas orthostatic tolerance (defined as area under the curve of upright SBP [AUCSBP]) improved similarly with binder and midodrine (AUCSBP, 195±35 and 197±41 versus 19±38 mm Hg×minute for placebo; P=0.003). Orthostatic symptom burden decreased with the binder (from 21.9±3.6 to 16.3±3.1, P=0.032) and midodrine (from 25.6±3.4 to 14.2±3.3, P<0.001), but not with placebo (from 19.6±3.5 to 20.1±3.3, P=0.756). We also compared the combination of midodrine and binder with midodrine alone. The combination produced a greater increase in orthostatic tolerance (AUCSBP, 326±65 versus 140±53 mm Hg×minute for midodrine alone; P=0.028, n=21) and decreased orthostatic symptoms (from 21.8±3.2 to 12.9±2.9, P<0.001). In conclusion, servo-controlled abdominal venous compression with an automated inflatable binder is as effective as midodrine, the standard of care, in the management of orthostatic hypotension. Combining both therapies produces greater improvement in orthostatic tolerance. CLINICAL

trial registrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT00223691.

Indexed as

Hypotension, OrthostaticIntermittent Pneumatic Compression DevicesMidodrineSplanchnic CirculationAgedAutonomic Nervous SystemBlood PressureBlood Pressure DeterminationFemaleHumansMaleMonitoring, PhysiologicTreatment OutcomeVasoconstrictor AgentsMidodrineVasoconstrictor Agentsautonomic nervous systemblood pressurehemodynamicmidodrineorthostatic hypotensionsplanchnic circulation

Identifiers

PMID27271310
PMCPMC4945429
OpenAlexW2411962200

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.