Dear Dr. SerVaas: Your articles in The Saturday Evening Post are great, and I have learned much. However, I have not noticed anything about fainting.

I am taking Pindolol, a beta blocker, every morning. This keeps me from fainting, but the side effects, while not horrendous, are not particularly desirable.

My cardiologist says my arteries are OK and that something in my nervous system causes the fainting. Do you have any suggestions for me?

Herb Weidman
Denver, Colorado

Dear Reader: Fainting, also called syncope, occurs when not enough blood flows to the brain. People sometimes faint when they stand up too quickly, hyperventilate, or have narrowing of arteries in the neck. As you mention, fainting may also result when a malfunction of the autonomic nervous system causes low blood pressure.

Physicians at Johns Hopkins Hospital say that the key step in treating neurally mediated hypotension (NMH) is for patients to drink at least two liters of fluids daily. Drinking extra fluids at regular intervals helps maintain a normal blood pressure and prevent fainting. For those who have been on a low-salt diet, they also recommend increasing sodium intake to help retain fluid in the blood vessels.

Beta blockers, like Pindolol, decrease the heart rate and help prevent forceful heart contractions that may trigger the fainting reflex. Other drugs which regulate blood pressure are sometimes prescribed.

Additional suggestions to help control NMH symptoms include wearing waist-high support hose, sleeping with the head of the bed elevated 10 to 15 degrees, and the avoidance of alcohol and caffeine.