The effect of fludrocortisone and midodrine on ambulatory blood pressure biomarkers and symptoms of syncope

Blood Pressure 2026 Open access

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Authors: Kate Doyle, Ciara P. Rice, Rose Anne Kenny, Robert Briggs, Amanda Hanora Lavan
DOI: 10.1080/08037051.2026.2618319
Cited by: 0
References: 21

Abstract

INTRODUCTION: Fludrocortisone and midodrine are frequently used to raise blood pressure (BP) in patients with vasovagal syncope (VVS)/low BP phenotype and orthostatic hypotension (OH), despite limited supporting evidence. This study assesses changes in Ambulatory Blood Pressure Monitor (ABPM) biomarkers and symptoms of syncope after commencing/increasing fludrocortisone or midodrine. METHODS: Patients attending a tertiary-referral falls & syncope unit and prescribed fludrocortisone/midodrine were included. ABPM at index visit and follow-up (after commencing/increasing fludrocortisone/midodrine) were analysed, with specific focus on biomarkers of syncope risk: overall systolic BP (sBP), minimum sBP, and 'dips' in sBP

Fields of Study & Subjects

Cardiovascular Syncope and Autonomic Disorders Blood Pressure and Hypertension Studies Heart Rate Variability and Autonomic Control

Publication details

Journal / source
Blood Pressure
Volume
35
Issue
1
Pages
2618319–2618319
Publication date
16 January 2026
Language
EN