Effect of Midodrine vs Abdominal Compression on Cardiovascular Risk Markers in Autonomic Failure Patients

This study is comparing two treatments — midodrine (a blood pressure-raising medication) and an abdominal compression binder — to see which better helps people with autonomic failure manage the dramatic drop in blood pressure they experience when standing up (called neurogenic orthostatic hypotension). **You may be eligible if...** - You are between 40 and 80 years old - You have been diagnosed with an autonomic failure condition, such as pure autonomic failure, multiple system atrophy, or Parkinson's disease - You experience a significant drop in blood pressure (≥20 mmHg) within 3 minutes of standing - You are willing and able to give informed consent **You may NOT be eligible if...** - You are pregnant - You cannot tolerate an abdominal compression device due to prior abdominal surgery, hernias, severe acid reflux, or rib fractures - You have certain heart or kidney conditions that would make the treatments unsafe Talk to your doctor to see if this trial is right for you.