Cardiology · Internal Medicine · 17 h ago
Carotid Sinus Hypersensitivity Often Coexists With Orthostatic Hypotension in Syncope
In a cohort of 1,908 adults aged 40 years or older evaluated for unexplained syncope, carotid sinus hypersensitivity (CSH) was more common in patients with orthostatic hypotension (OH). The observational findings suggest the conditions can coexist and may support assessing both during syncope evaluation.
- CSH occurred in 24.1% of patients with OH.
- Nearly half of patients with CSH also had OH.
- Asystolic massage responses were more frequent with OH.
Researchers analyzed 1,908 patients aged 40 years or older with unexplained syncope who underwent carotid sinus massage and head-up tilt testing. The mean age was 63.7 years, and 45.3% were men. The study assessed CSH in patients with classical or delayed OH, including asystolic responses to carotid sinus massage.
OH was identified in 618 patients (32.4%) and CSH in 320 (16.8%). CSH was more frequent among patients with OH than among those without it (24.1% vs. 13.3%; p<0.001). Of patients with CSH, 46.6% also had OH. CSH prevalence was similar in classical and delayed OH. Asystolic responses occurred in 6.8% of patients with OH and 3.4% of those without OH (p<0.001).
The findings indicate that these potential contributors to syncope are not mutually exclusive and that carotid sinus massage may identify an asystolic response in some patients with OH. The cohort findings support considering both tests in evaluation, but do not establish that combined testing improves outcomes or changes management; full text was not available in the supplied source.
In practice
Among adults aged 40 years or older evaluated for unexplained syncope, CSH and OH frequently coexisted: CSH was found in 24.1% of patients with OH, and 46.6% of patients with CSH also had OH. These observational findings support considering both conditions during syncope evaluation, including carotid sinus massage and tilt testing where clinically appropriate. The study does not show that combined testing improves outcomes or establishes a management change, and its findings may not apply beyond the evaluated population.
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Europace: Coexistance of Carotid Sinus Hypersensitivity and Orthostatic Hypotension in Patients with Unexplained Syncope ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.