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Hi, we are VERY interested in this item, as Jack used tablets to keep his BP "down" - "just in case" - (it never was up), and nitro (tabs and then the patch) for over 10 years for what we were told was angina, but probably was anxiety and the depression that sometimes first present before the PD or SDS symptoms appear. Jack ended up having triple bypass heart surgery in April '94. Before that the nitro dosage kept being increased by the doctor and then it didn't seem to help at all. About 6 months after the surgery the SDS gait and small handwriting appeared. He'd had nocturia (bed wetting) and dizzy spells for two years before that, but we were told he had prostate problems and the dizzies would clear up if he had the bypass surgery (which of course, they didn't). When Jack was first diagnosed, we searched for info and one of the articles we rec'd from NORD (I think) said, "Approximately one third of consultations for chronic orthostatic hypotension in Vanderbuilt University Hospital ultimately lead to a diagnosis of autonomic neuropathy.....Although it is relatively uncommon, angina pectoris may occasionally accompany autonomic failure. Since most physical exertion during daily activity occurs during upright posture, the chest pain may appear to have a typical relation to effort. HOWEVER, IT IS OF THE GREATEST IMPORTANCE THAT NITROGLYCERIN BE AVOIDED IN THIS PATIENT POPULATION, SINCE PROFOUND HYPOTENSION AND EXACERBATION OF AGINA IS LIKELY TO OCCUR. We couldn't believe it when we read it! All those years of taking nitro, probably just made Jack sicker. We have searched for other info re nitro and angina but have been unable to find anything else. Anyone have similar experience with chest pain (angina) and nitroglycerin? Jack and Joan Martin, Oshawa, Ontario, Canada PS: We are very glad that Dr. Robertson is writing a book on SDS and hope that it will help enlighten the medical profession and patients alike to the signs and symptoms of MSA. -------------------------------------------- At 10:25 22/09/96 -0400, you wrote: >Recently I wrote you about a flare-up in Fay's blood pressure and you >suggested that I write back with the medications that she received in the >hospital. > >The problem was that suddenly we were getting high readings in the daytime >and very high readings at night, even with nitro patches. I found myself >patching her in the daytime when she was sitting. After several days of >telephone reporting and an office call, Fay was put in the hospital. The >local G.P's tried some approaches new to us and were successful in >controlling the B.P. In fact, very shortly after her admission the B.P. >dropped and behaved somewhat normaly, given SDS. > >The first night they gave her one Nifedimine tablet 10 mg. at bedtime and >used nitro paste in addition, as needed. They succeeded in controlling her >B.P. very well. The problem was that she was virtually wiped out, apparently >from the Nifedimine. No strength. The following nights thy controlled her >with nitro paste only. > >After several days of relative normalcy she was discharged with a regimen of >the Nifedimine and nitro paste. One night was enough. She was out of it the >next day. We are back on the nitro patches. > >Manson A. Donaghey >Pembroke, NH > >