A drug application that is “smart” enough to know when to boost blood pressure and when to leave it alone has been discovered by researchers at the Mayo Clinic. The drug, pyridostigmine, has been used for years for myasthenia gravis, a neuromuscular transmission disorder. But Phillip Low, neurologist and lead study investigator found it can also alleviate orthostatic hypotension — a problem with sinking blood pressure when standing up from a sitting position — without the unwanted effect of also causing patients’ blood pressure to soar when lying down. “We wanted a ‘smart drug’ that would only increase blood pressure when standing up, and not when lying down,” said Low. Pyridostigmine works at the level of the autonomic ganglion, which has minimal nerve signaling traffic when lying down. Of the 58 patients in the study, one-third were able to stop taking any other orthostatic hypotension medications, and others were able to lower the amount of other drugs needed. Orthostatic hypotension is especially common in those over age 70, Low said. © Copyright 2004 by United Press International

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