Prevention of glucose-induced hypotension by the somatostatin analogue octreotide (SMS 201-995) in chronic autonomic failure: Haemodynamic and hormonal changes

S. J. Raimbach, P. Cortelli, J. S. Kooner, R. Bannister, S. R. Bloom, C. J. Mathias

Research output: Contribution to journalArticle

Abstract

1. The haemodynamic and hormonal changes following glucose ingestion (1 g/kg) were determined before and after pretreatment with either placebo or the somatostatin analogue, octreotide (SMS 201-995, 50 μg subcutaneously), in seven patients with chronic autonomic failure. 2. In the placebo phase, after glucose, there was a marked and prolonged fall in blood pressure with no change in cardiac index and peripheral blood flow. Plasma insulin and neurotensin levels increased, whereas glucagon, vasoactive intestinal polypeptide, noradrenaline and adrenaline levels were unchanged. 3. Octreotide transiently raised blood pressure and prevented glucose-induced hypotension. There were no changes in cardiac index or peripheral blood flow. Plasma insulin and neurotensin levels did not rise. Plasma glucose levels increased more slowly but reached a similar level to the placebo phase. 4. We conclude that in autonomic failure patients, glucose-induced hypotension was not accompanied by changes in cardiac index or peripheral blood flow, indicating a lack of compensation to probable splanchnic vasodilatation. The hypotension was prevented by the peptide release inhibitor, octreotide, with no change in cardiac index or in peripheral blood flow, suggesting an effect on the splanchnic vasculature, probably through inhibiting release of vasodilatatory pancreatic and gut peptides.

Original languageEnglish
Pages (from-to)623-628
Number of pages6
JournalClinical Science
Volume77
Issue number6
Publication statusPublished - 1989

Keywords

  • Autonomic failure
  • Glucose
  • Postprandial hypotension
  • Regulatory peptides
  • Somatostatin
  • Sympathetic nervous system

ASJC Scopus subject areas

  • Medicine(all)

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