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Release of antidiuretic hormone in quadriplegic subjects in response to head-up tilt

Neurology Service, Veterans Administration Medical Center, East Orange, and the Department of Neurosciences, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ (Dr. Sved); and the Burke Rehabilitation Center, Westchester Division of Cornell University Medical College, White Plains, NY (Drs. McDowell and Blessing), and Department of Neurology, Cornell University Medical College, New York. NY (Dr. Blessing).

Plasma antidiuretic hormone (ADH) levels during head-up tilt were measured in quadriplegic patients and normal healthy subjects. In normal subjects, neither rapid tilt (from horizontal to 70° head-up in 20 seconds and remaining head-up for 5 minutes) nor gradual tilt (from horizontal to 70° head-up over 15 minutes) significantly changed the plasma ADH level. In contrast, rapid tilt elevated plasma ADH levels approximately fourfold in quadriplegic subjects. A less dramatic elevation in plasma ADH levels followed gradual tilt in quadriplegic subjects. These data, along with the possibility that the pressor potency of ADH is enhanced in quadriplegic subjects, suggest that ADH is involved in the maintenance of blood pressure in quadriplegics in a head-up position.

Address correspondence and reprint requests to Dr. Sved, Neurology Service (127). VA Medical Center, East Orange, NJ 07019.

Supported in part by a grant from the Foundation of the University of Medicine and Dentistry of New Jersey.

Accepted for publication April 20, 1984.

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