Heat for hypertension in autonomic failure

Patients with autonomic failure—a neurodegenerative disorder characterized by a disabling drop in blood pressure on standing (orthostatic hypotension, OH)—commonly have increased blood pressure when lying down. This supine hypertension, which is difficult to manage overnight, is associated with end-organ damage and can worsen daytime OH.

Luis Okamoto, MD, and colleagues explored using local heat to lower blood pressure in people with autonomic failure. They tested the effects of acute (two hours) and overnight (eight hours) local heat therapy.

The researchers reported in the Journal of the American Heart Association that acute local heat lowered blood pressure with a rapid onset and recovery, and overnight heat effectively lowered blood pressure and improved nocturnal diuresis and morning OH.

With additional study, overnight heat therapy may offer a novel nonpharmacologic approach to treat nocturnal supine hypertension in patients with autonomic failure, the authors suggest.