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ME/CFS Science @mecfsscience.org · 17/05/2026

4) Ivabradine also increased systolic blood pressure (bit of a surprise), but there was no obvious effect on symptoms. The authors used questionnaires such as the RAND-36, COMPASS-31, and the Vanderbilt Orthostatic Symptom Score (VOSS), with no clear overall effect on either.

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ME/CFS Science @mecfsscience.org · 17/05/2026

5) Some questionnaires did hint at lower orthostatic symptoms for ivabradine, particularly on the orthostatic grading scale (but it seems that the study didn't correct for multiple comparisons). A reduction in heart rate but not symptoms was also reported by the RECOVER trial.

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ME/CFS Science @mecfsscience.org · 17/05/2026

6) These results could mean that the high heart rate in POTS isn't strongly connected to most of the symptoms and disability that patients experience. We wrote about this hypothesis here, but acknowledge that more data is needed to clarify this issue:

mecfsscience.org

The problems with POTS - ME/CFS Science

The diagnostic criteria for postural orthostatic tachycardia syndrome (POTS) have been questioned by several researchContinue readingThe problems with POTS

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