Newton, Julia L, Sheth, Amish, Shin, Jane et al. · Psychosomatic medicine · 2009 · DOI
This study measured blood pressure patterns over 24 hours in people with ME/CFS, healthy volunteers, and people with a liver disease that also causes fatigue. The researchers found that ME/CFS patients had lower blood pressure than healthy people and their blood pressure did not drop as much during sleep as it normally should. Higher fatigue levels were linked to these abnormal blood pressure patterns.
This study provides objective physiological evidence of abnormal blood pressure regulation in ME/CFS, suggesting an autonomic nervous system component to the disease. These findings may explain fatigue symptoms and could guide future targeted treatments, such as blood pressure-raising medications, for a subset of ME/CFS patients.
This observational study cannot establish causation—lower blood pressure may result from reduced activity in CFS rather than causing fatigue. The study does not prove that midodrine or other pressor agents would be effective treatments, only that a trial would be warranted. Cross-sectional blood pressure monitoring cannot determine whether abnormal diurnal variation precedes or develops after CFS onset.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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