Interactive diabetes case 20: A 76-year-old patient with longstanding type 2 diabetes, orthostatic hypotension, and recurrent syncope – A4

Answer — Incorrect.

Clonidine has no role in the treatment of autonomic orthostatic hypotension. It is a centrally acting alpha-2 agonist and is used to treat hypertension in patients without autonomic dysfunction. In patients with autonomic orthostatic hypotension, the agonist effect on peripheral vascular alpha-2 receptors may increase the blood pressure. However, in these patients, it is not possible to predict whether the central antihypertensive effect will reduce the blood pressure in these already hypotensive patients or whether the peripheral vascular effect will increase the upright blood pressure as desired.

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