Orthostatic hypotension as cause of syncope in patients older than 65 years admitted to emergency departments for transient loss of consciousness

Journals of Gerontology - Series A Biological Sciences and Medical Sciences

Volumn 64, Issue 7, 2009, Pages 801-806

  Mussi, Chiara ^a   Ungar, Andrea ^b   Salvioli, Gianfranco ^a   Menozzi, Carlo ^c   Bartoletti, Angelo ^d   Giada, Franco ^e   Lagi, Alfonso ^d   Ponassi, Irene ^f   Re, Giuseppe ^g   Furlan, Raffaello ^h   Maggi, Roberto ⁱ   Brignole, Michele ⁱ  

^a UNIVERSITY OF MODENA AND REGGIO EMILIA   (Italy)

^b UNIVERSITY OF FLORENCE   (Italy)

^c S MARIA NUOVA HOSPITAL   (Italy)

^d SANTA MARIA ANNUNZIATA HOSPITAL   (Italy)

^e Ospedale Umberto I   (Italy)

^f UNIVERSITY OF GENOA   (Italy)

^g UNIVERSITY OF BOLOGNA   (Italy)

^h UNIVERSITY OF MILAN   (Italy)

ⁱ DEPARTMENT OF CARDIOLOGY   (Italy)

Author keywords

Adverse drug reaction; Diagnosis; Emergency department; Older; Orthostatic hypotension

Indexed keywords

ANTIARRHYTHMIC AGENT; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CALCIUM CHANNEL BLOCKING AGENT; DIGOXIN; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; DIURETIC AGENT; NEUROLEPTIC AGENT; NITRATE;

AGED; ARTICLE; CLINICAL FEATURE; DISEASE ASSOCIATION; DRUG USE; EMERGENCY WARD; FEMALE; HUMAN; MAJOR CLINICAL STUDY; MALE; NEUROLOGIC DISEASE; ORTHOSTATIC HYPOTENSION; PARKINSON DISEASE; PREVALENCE; PRIORITY JOURNAL; QT INTERVAL; RISK ASSESSMENT; RISK FACTOR; ST SEGMENT; SYNCOPE; UNCONSCIOUSNESS; ELECTROCARDIOGRAPHY; EMERGENCY HEALTH SERVICE; FALLING; ITALY; PRACTICE GUIDELINE; PROSPECTIVE STUDY; STATISTICS;

SYNCOPE;

ACCIDENTAL FALLS; AGED; AGED, 80 AND OVER; DIGOXIN; DIURETICS; ELECTROCARDIOGRAPHY; EMERGENCY SERVICE, HOSPITAL; FEMALE; HUMANS; HYPOTENSION, ORTHOSTATIC; ITALY; MALE; NITRATES; PARKINSON DISEASE; PRACTICE GUIDELINES AS TOPIC; PREVALENCE; PROSPECTIVE STUDIES; RISK FACTORS; SYNCOPE, VASOVAGAL;

EID: 67649655965     PISSN: 10795006     EISSN: None     Source Type: Journal    
DOI: 10.1093/gerona/glp028     Document Type: Article

References (24)

1. Disertori M, Brignole M, Menozzi C, et al. Management of syncope referred for emergency to general hospitals. Europace. 2003;5:283-291.
2. Ammirati F, Colivicchi F, Santini M. Diagnosing syncope in the clinical practice. Implementation of a simplifi ed diagnostic algorithm in a multicentre prospective trial - the OESIL 2 study (Osservatorio Epidemiologico della Sincope nel Lazio). Eur Heart J. 2000;21:935-940.
3. American College of Emergency Physicians. Clinical policy: critical issues in the evaluation and management of patients presenting with syncope. Ann Emerg Med. 2001;37:771-776.
4. Brignole M, Alboni P, Benditt D, et al. Guidelines on management (diagnosis and treatment) of syncope. Eur Heart J. 2001;22:1256-1306.
5. Brignole M, Alboni P, Benditt D, et al. Guidelines on management (diagnosis and treatment) of syncope - update 2004-Executive summary and recommendations. Eur Heart J. 2004;25:2054-2072.
6. Gupta V, Lipsitz LA. Orthostatic hypotension in the elderly: diagnosis and treatment. Am J Med. 2007;120:841-847.
7. Sarasin FP, Louis-Simonet M, Carballo D, Slama S, Junod AF, Unger PF. Prevalence of orthostatic hypotension among patients presenting with syncope in the ED. Am J Emerg Med. 2002;20:497-501.
8. Kapoor WN. Syncope. N Engl J Med. 2000;343:1856-1862.
9. Brignole M, Menozzi C, Bartoletti A, et al., for the Evaluation of Guidelines in Syncope Study 2 (EGSYS-2) group. A new management of syncope: prospective systematic guideline-based evaluation of patients referred urgently to general hospitals. Eur Heart J. 2006;27:76-82.
10. The Consensus Committee of the American Autonomic Society and the American Academy of Neurology. Consensus statement on the defi nition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. Neurology. 1996;46:1470.
11. Position paper: Orthostatic hypotension, multiple system atrophy (the Shy-Drager syndrome), and pure autonomic failure. J Auton Nerv Syst. 1996;58:123-124.
12. Smit AA, Halliwill JR, Low PA, Wieling W. Pathophysiological basis of orthostatic hypotension in autonomic failure. J Physiol. 1999;519:1-10.
13. Diedrich A, Biaggioni I. Segmental orthostatic fl uid shifts. Clin Auton Res. 2004;14:146-147.
14. Ungar A, Mussi C, Del Rosso A, et al., for the Italian Group for the Study of Syncope in the Elderly. Diagnosis and characteristics of syncope in older patients referred to geriatric departments. J Am Geriatr Soc. 2006;54:1531-1536.
15. Rutan GH, Hermanson B, Bild DE, Kittner SJ, LaBaw F, Tell GS. Orthostatic hypotension in older adults. The Cardiovascular Health Study CHS. Hypertension. 1992;19:508-519.
16. Graafmans WC, Ooms ME, Hofstee HM, Bezemer PD, Bouter LM, Lips P. Falls in the elderly. A prospective study of risk factors and risk profi les. Am J Epidemiol. 1996;143:1129-1136.
17. Masaki KH, Shatz IJ, Burchfi el CM, et al. Orthostatic hypotension predicts mortality in elderly men. The Honolulu Heart Program. Circulation. 1998;98:2290-2295.
18. Sun BC, Emond JA, Camargo CA. Direct medical costs of syncoperelated hospitalizations in the United States. Am J Cardiol. 2005;95:668-671.
19. Gibbons CH, Freeman R. Delayed orthostatic hypotension. A frequent cause of orthostatic intolerance. Neurology. 2006;67:28-32.
20. Linzer M, Yang EH, Estes NA III, Wang P, Vorperian VR, Kapoor WN. Diagnosing syncope. Part 1. Ann Intern Med. 1997;126:989-996.
21. Gaeta TJ, Fiorini M, Ender K, Bove J, Diaz J. Potential drug-drug interactions in elderly patients presenting with syncope. J Emerg Med. 2002;22:159-162.
22. Van der Velde N, van den Meiracker AH, Pols HAP, Stricker BH, van der Cammen TJM. Withdrawal of fall-risk-increasing drugs in older persons: effect on tilt-table test outcomes. J Am Geriatr Soc. 2007;55:734-739.
23. Sarasin FP, Louis-Simonet M, Carballo D, et al. Prospective evaluation of patients with syncope. Am J Med. 2001;111:177-184.
24. Goldstein DS, Eldadah BA, Holmes C, et al. Neurocirculatory abnormalities in Parkinson disease with orthostatic hypotension. Independence from Levodopa treatment. Hypertension. 2005;46:1333-1339.