Carbonated Water for Orthostatic Hypotension

Overseen By Vera-Ellen M Lucci, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Simon Fraser University

Disqualifiers: Pregnancy, Cardiovascular, Neurological, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

Duration: 1 week

25 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if carbonated water can help maintain steady blood pressure when standing, potentially preventing dizziness or fainting. Researchers seek to discover whether fizzy water is more effective than still water for this purpose. Participants will drink different types of water on separate days to assess the effects. This trial is ideal for healthy individuals who speak English and have no history of fainting or heart and neurological issues. As an unphased trial, participants contribute to innovative research exploring everyday solutions for common health issues.

Do I need to stop my current medications for the trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What prior data suggests that water carbonation is safe for improving orthostatic tolerance?

Research has shown that carbonated water is generally safe for most people. Studies have found that it can help with low blood pressure, especially after exercise when blood pressure often drops. Specifically, drinking carbonated water temporarily improved blood flow to the brain during this time, indicating good tolerance.

A review of various studies also supports the idea that sparkling water is safe and can aid in hydration. No major reports of side effects or negative reactions have been linked to its use, suggesting that carbonation does not add significant risks compared to regular water.

Overall, while carbonated water is not a new treatment, it is not known to cause safety concerns. However, those with specific health conditions should consult a healthcare professional before joining any study. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using carbonated water for orthostatic hypotension because it offers a simple and non-invasive approach that differs from typical medications like fludrocortisone or midodrine. Unlike these drugs, carbonated water is safe, accessible, and has no known side effects, making it an appealing option for patients who don't tolerate medication well. The carbonation in the water may work by increasing blood pressure more rapidly and effectively than still water, potentially providing quick relief for patients who experience dizziness or fainting when standing up.

What evidence suggests that this trial's treatments could be effective for orthostatic hypotension?

Research has shown that drinking cold or fizzy water can help raise blood pressure, which benefits people with orthostatic hypotension, a condition causing dizziness or fainting upon standing. This trial will examine the effects of carbonated water on blood pressure stability. Participants will be assigned to different arms, each testing various sequences of carbonated and still water consumption. Studies suggest that fizzy water might boost blood pressure more effectively than regular water and may help the body manage blood flow better, potentially preventing fainting. Although more research is needed, these findings indicate that fizzy water might be more effective at maintaining stable blood pressure when standing. ^{1 6 7 8 9}

Who Is on the Research Team?

Victoria E Claydon, PhD

Principal Investigator

Professor, Biomedical Physiology and Kinesiology

Are You a Good Fit for This Trial?

This trial is for healthy, English-speaking individuals without a history of cardiovascular or neurological diseases, not pregnant, and who haven't fainted more than once in the past six months. It's designed to see if carbonated water helps people maintain blood pressure when standing up.

Inclusion Criteria

English-speaking

This criterion means that the participant should be in good health with no major medical conditions.

Exclusion Criteria

I have a history of heart disease.

I have a history of a neurological condition.

Pregnancy or suspected pregnancy

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants undergo a tilt test on three separate days, drinking different types of water to assess orthostatic tolerance.

1 week

3 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

1-2 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Water Carbonation

Trial Overview The study tests whether drinking 500mL of carbonated water improves orthostatic tolerance—the ability to keep blood pressure stable when standing—compared to the same amount of still water. A smaller volume (50mL) of still water serves as an additional control.

How Is the Trial Designed?

Group I: 50mL still water first, then 500mL still water, then 500 mL carbonated water Experimental Treatment 3 Interventions

Participants will undergo this test on three separate days. On each day participants will be asked to drink a glass of water: either a 50mL drink of still water (control condition), a 500mL drink of still (non-carbonated) water, or a 500mL drink of carbonated water. In this arm of the study, participants will receive 50mL still water on the first test day, 500mL carbonated water on the second test day, then 500mL carbonated water on the third day.

Group II: 50mL still water first, then 500mL carbonated water, then 500 mL still water Experimental Treatment 3 Interventions

Participants will undergo this test on three separate days. On each day participants will be asked to drink a glass of water: either a 50mL drink of still water (control condition), a 500mL drink of still (non-carbonated) water, or a 500mL drink of carbonated water. In this arm of the study, participants will receive 50mL still water on the first test day, 500mL still water on the second test day, then 500mL still water on the third day.

Group III: 500mL still water first, then 50mL still water, then 500 mL carbonated water Experimental Treatment 3 Interventions

Participants will undergo this test on three separate days. On each day participants will be asked to drink a glass of water: either a 50mL drink of still water (control condition), a 500mL drink of still (non-carbonated) water, or a 500mL drink of carbonated water. In this arm of the study, participants will receive 500mL still water on the first test day, 50mL still water on the second test day, then 500mL carbonated water on the third day.

Group IV: 500mL still water first, then 500 mL carbonated water, then 50mL still water Experimental Treatment 3 Interventions

Participants will undergo this test on three separate days. On each day participants will be asked to drink a glass of water: either a 50mL drink of still water (control condition), a 500mL drink of still (non-carbonated) water, or a 500mL drink of carbonated water. In this arm of the study, participants will receive 500mL still water on the first test day, 500mL carbonated water on the second test day, then 50mL still water on the third day.

Group V: 500mL carbonated water first, then 50mL of still water, then 500mL of still water Experimental Treatment 3 Interventions

Participants will undergo this test on three separate days. On each day participants will be asked to drink a glass of water: either a 50mL drink of still water (control condition), a 500mL drink of still (non-carbonated) water, or a 500mL drink of carbonated water. In this arm of the study, participants will receive 500mL carbonated water on the first test day, 50mL still water on the second test day, then 500mL still water on the third day.

Group VI: 500mL carbonated water first, then 500mL of still water, then 50mL of still water Experimental Treatment 3 Interventions

Participants will undergo this test on three separate days. On each day participants will be asked to drink a glass of water: either a 50mL drink of still water (control condition), a 500mL drink of still (non-carbonated) water, or a 500mL drink of carbonated water. In this arm of the study, participants will receive 500mL carbonated water on the first test day, 500mL still water on the second test day, then 50mL still water on the third day.

Who Is Running the Clinical Trial?

Simon Fraser University

Lead Sponsor

Trials

59

Recruited

12,500+

Published Research Related to This Trial

In a study involving 19 healthy young women, drinking carbonated water (CW) significantly increased feelings of fullness compared to regular water (W), suggesting a short-term satiating effect.

The consumption of CW also resulted in a higher heart rate, indicating that the satiating effect may be linked to increased sympathetic nervous system activity, which could enhance gastric and cardiac responses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of carbonated water upon gastric and cardiac activities and fullness in healthy young women. Wakisaka, S., Nagai, H., Mura, E., et al.[2019]

A study involving 8,894 high-school blood donations found that providing a 473-mL water drink significantly reduced the rate of vasovagal reactions during donations, with a 21% decrease in reactions compared to those who did not receive water.

The most notable benefits were observed in Caucasian, first-time donors, and the water drink did not interfere with the donation process, making it an easy and effective intervention for improving donor safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of a 473-mL (16-oz) water drink on vasovagal donor reaction rates in high-school students. Newman, B., Tommolino, E., Andreozzi, C., et al.[2022]

In a study involving 13 healthy subjects, drinking 500 mL of water significantly improved orthostatic tolerance by an average of 5 minutes, indicating that hydration can enhance the body's ability to handle changes in posture.

The improvement in orthostatic tolerance was linked to increased blood pressure and better regulation of cerebral blood flow, suggesting that water drinking elicits beneficial hemodynamic changes in healthy individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Water drinking acutely improves orthostatic tolerance in healthy subjects. Schroeder, C., Bush, VE., Norcliffe, LJ., et al.[2019]

Drinking cold or cold carbonated water significantly increases blood pressure more than room temperature water in both younger (average age 19.9) and older adults (average age 71.4), with the effect being stronger in older adults.

The pressor response from drinking cold and carbonated water is not only immediate but also persists during the recovery period, suggesting it could be an effective first aid method for managing acute hypotension.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Pressor Response to the Drinking of Cold Water and Cold Carbonated Water in Healthy Younger and Older Adults. Kubota, S., Endo, Y., Kubota, M., et al.[2022]

Drinking 480 mL of water significantly increased blood pressure in patients with severe orthostatic hypotension due to autonomic failure, demonstrating a rapid pressor response that can be beneficial for treatment.

In patients with idiopathic orthostatic intolerance, water drinking not only helped raise blood pressure but also reduced heart rate during episodes of orthostatic tachycardia, suggesting it could be a useful adjunctive therapy for managing these conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Water drinking as a treatment for orthostatic syndromes. Shannon, JR., Diedrich, A., Biaggioni, I., et al.[2019]

Drinking water can significantly help patients with autonomic failure by increasing blood pressure and reducing symptoms of severe orthostatic hypotension, making it a simple and effective treatment option.

In patients with orthostatic intolerance, water drinking reduces heart rate increases but has a limited effect on blood pressure, suggesting that the cardiovascular response involves sympathetic activation, although the exact mechanism remains unclear.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acute effect of water on blood pressure. What do we know? Jordan, J.[2007]

Both nonpharmacologic and pharmacologic treatments can effectively reduce symptoms of orthostatic hypotension, with new strategies emerging based on recent insights into the condition's underlying mechanisms.

Patients with severe autonomic failure may benefit significantly from simple interventions like drinking water, which can trigger a strong blood pressure response, highlighting the importance of personalized treatment approaches.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

New trends in the treatment of orthostatic hypotension. Jordan, J.[2019]

In a study of 9 patients with orthostatic hypotension, drinking plain water significantly increased systolic blood pressure (SBP) more than drinking salt water, suggesting that water alone is more effective for managing blood pressure in these patients.

The addition of salt to water actually reduced the blood pressure response, indicating that gastrointestinal osmolality may play a crucial role in activating the sympathetic nervous system and enhancing the gastropressor response.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sodium paradoxically reduces the gastropressor response in patients with orthostatic hypotension. Raj, SR., Biaggioni, I., Black, BK., et al.[2016]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/35095733/

The Pressor Response to the Drinking of Cold Water and ... This study aimed to investigate whether drinking water with a cold or carbonation stimulus would cause a more effective pressor response.

2. clinicaltrials.gov clinicaltrials.gov/study/NCT05621460

The Effect of Water Carbonation on Orthostatic Tolerance | ... The primary purpose of this investigation is to determine whether water carbonation can improve orthostatic tolerance in healthy control volunteers.

3. frontiersin.org frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.788954/full

The Pressor Response to the Drinking of Cold Water and ... Drinking cold water or cold carbonated water for orthostatic pre-syncope may increase blood pressure and improve baroreflex function. Although ...

4. physoc.onlinelibrary.wiley.com physoc.onlinelibrary.wiley.com/doi/full/10.1113/EP091925

Ingesting carbonated water post‐exercise in the heat ... We show that carbonated water ingestion temporarily ameliorates hypotension and increases the cerebral blood flow index during the early post-exercise phase in ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8793880/

The Pressor Response to the Drinking of Cold Water and ... Purpose: Water drinking has been proposed for the treatment of orthostatic hypotension because it can increase blood pressure in patients.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11442846/

Ingesting carbonated water post‐exercise in the heat ... We show that carbonated water ingestion temporarily ameliorates hypotension and increases the cerebral blood flow index during the early post‐exercise phase in ...

7. signos.com signos.com/blog/is-seltzer-water-bad-for-you

Is Seltzer Water Bad for You? Health Risks and Benefits - Signos Seltzer and sparkling water are generally safe for most people and can help you meet optimal fluid intake. Health benefits include improved ...

8. researchgate.net researchgate.net/publication/382691360_Systematic_Review_of_the_Effects_of_Sparkling_Water_Consumption_on_Blood_Pressure

Systematic Review of the Effects of Sparkling Water ... This review is an examination of the literature on the impact of carbonated water consumption on the blood pressure of hypertensive patients.

9. centerwatch.com centerwatch.com/clinical-trials/listings/NCT05621460/the-effect-of-water-carbonation-on-orthostatic-tolerance

The Effect of Water Carbonation on Orthostatic Tolerance The primary purpose of this investigation is to determine whether water carbonation can improve orthostatic tolerance in healthy control ...