{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:07:44Z","timestamp":1792112864128,"version":"4.4.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,10,11]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Orthostatic hypotension causes \u224880\u00a0000 hospitalizations per year in the United States. Treatments for orthostatic hypotension include fludrocortisone, a mineralocorticoid analog that promotes sodium reabsorption; and midodrine, an \u03b1\u20101 adrenergic agonist that is a direct vasoconstrictor. Although both medications are used to treat orthostatic hypotension, few studies have compared their relative safety.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We compared incidence rates of hospitalizations for all causes, and for congestive heart failure between users of fludrocortisone and users of midodrine in a retrospective cohort study of Tennessee Medicaid adult enrollees (1995\u20132009). Adjusted incidence rate ratios were calculated using negative binomial regression models. Subgroup analyses based on history of congestive heart failure were conducted. We studied 1324 patients initiating fludrocortisone and 797 patients initiating midodrine. Compared with fludrocortisone users, midodrine users had higher prevalence of cardiovascular conditions. Incidence rates of all\u2010cause hospitalizations for fludrocortisone and midodrine users were 1489 and 1330 per 1000\u00a0person\u2010years, respectively (adjusted incidence\u2010rate ratio 1.20, 95% confidence interval, 1.02\u20131.40). The respective rates of heart failure\u2013related hospitalization were 76 and 84 per 1000\u00a0person\u2010years (adjusted incidence\u2010rate ratio: 1.33, 95% confidence interval, 0.79\u20132.56). Among patients with a history of congestive heart failure, the rates of all\u2010cause hospitalization for fludrocortisone and midodrine were 2448 and 1820 per 1000\u00a0person\u2010years (adjusted incidence\u2010rate ratio: 1.42, 95% confidence interval, 1.07\u20131.90), and the respective rates of heart failure exacerbation\u2013related hospitalizations were 297 and 263 per 1000\u00a0person\u2010years (adjusted incidence\u2010rate ratio: 1.48, 95% confidence interval, 0.69\u20133.16).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Compared with users of midodrine, users of fludrocortisone had higher rates of all\u2010cause hospitalizations, especially among patients with congestive heart failure.<\/jats:p>\n          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