Toggle Main Menu Toggle Search

Open Access padlockePrints

The relationship between carotid sinus hypersensitivity, orthostatic hypotension, and vasovagal syncope: a case-control study

Lookup NU author(s): Dr Maw Tan, Emerita Professor Julia Newton, Dr Thomas Chadwick, Dr Steve Parry


Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


Aims Previous uncontrolled studies reported an overlap between carotid sinus hypersensitivity (CSH), vasovagal syncope (VVS), and orthostatic hypotension ( OH). We conducted a case-control study evaluating this relationship in a large patient cohort. Methods and results The electronically stored continuous electrocardiograph and blood pressure ( BP) measurements for active stand and head-up tilt-table ( HUT) tests of 302 consecutive patients investigated with carotid sinus massage ( CSM) were analysed. Carotid sinus hypersensitivity was defined as >= 3 s asystole and/or systolic BP ( SBP) drop of >= 50 mmHg during CSM. Orthostatic hypotension was defined as BP reductions of >= 20 mmHg systolic or of >= 10 mmHg diastolic, whereas VVS was diagnosed with a positive HUT test. There was no significant difference in the number of subjects with OH ( 57 vs. 55%; P = 0.778) or HUT-positive VVS ( 45 vs. 47%; P = 0.828) between cases with CSH and controls without CSH. Carotid sinus hypersensitivity subjects had significantly larger SBP reduction ( P = 0.039) and longer time to nadir ( P = 0.007) during active stand, and trends to vasodepressor ( P = 0.071) and dysautonomic responses to HUT ( P = 0.151). Conclusion Carotid sinus hypersensitivity, OH, and VVS are common conditions affecting patients with syncope and falls which are likely to co-exist in such individuals. The differences in haemodynamic response patterns to active stand and HUT in CSH subjects could be the result of an age-associated delay in sympathetic responses.

Publication metadata

Author(s): Tan MP, Newton JL, Chadwick TJ, Parry SW

Publication type: Article

Publication status: Published

Journal: Europace

Year: 2008

Volume: 10

Issue: 12

Pages: 1400-1405

ISSN (print): 1099-5129

ISSN (electronic): 1532-2092

Publisher: Oxford University Press


DOI: 10.1093/europace/eun278


Altmetrics provided by Altmetric