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Exercise Training Effective Therapy for Patients With POTS

For patients with postural orthostatic tachycardia syndrome, quality of life improved by training

WEDNESDAY, June 22 (HealthDay News) -- Exercise training may be a more effective therapy for patients with postural orthostatic tachycardia syndrome (POTS) than β-blockers, according to a study published in the July issue of Hypertension.

Qi Fu, M.D., Ph.D., from the Texas Health Presbyterian Hospital Dallas, and colleagues investigated whether exercise training was superior to standard drug therapies such as β-blocker treatment for improving symptoms, hemodynamics, and renal-adrenal responses in 19 patients with POTS. Participants were randomized to receive either propranolol or a placebo for four weeks, which was followed by three months of exercise training, and were compared with 15 age-matched healthy controls. Hemodynamics, catecholamines, plasma renin activity, and aldosterone were measured when participants were supine and during a two-hour standing test, performed before and after drug treatment and training. Patient quality of life was assessed using the 36-item Short-Form Health Survey.

The investigators found that the standing heart rate was significantly lowered after both propranolol and exercise training. Cardiac standing output was significantly reduced after propranolol treatment, but there was a small reduction after training. The aldosterone-to-renin ratio during two-hour standing was marginally improved after training (P = 0.05), but did not change after propranolol treatment (P = 0.46). Neither propranolol nor training had an effect on plasma catecholamines. Patient quality of life was significantly improved after training, but not propranolol treatment.

"Given the fact that exercise training but not propranolol treatment improved adrenal function, POTS symptoms, and, most importantly, patient quality of life, it is reasonable to conclude that this nondrug therapy is superior toβ-blockers," the authors write.

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