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Lookup NU author(s): Dr Gordon Duncan,
Dr Maw Tan,
Emerita Professor Julia Newton,
Dr Steve Parry
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Methods: 1,060 consecutive patients with tilt-positive VVS were identified from a prospective database containing the demographic and clinical information of individuals assessed in our unit over a 10-year period. VVS was diagnosed with appropriate haemodynamic changes during HUTT and accompanying symptom reproduction. Results: we found a bimodal age distribution with a small peak at 20-29 years and a larger peak at 70-79 years. Patients aged >= 60 years were less likely to report total loss of consciousness [odds ratio (OR) 0.50, 95% confidence interval (CI) = 0.38-0.64], near loss of consciousness (OR 0.53, 95% CI = 0.40-0.70) or palpitations (OR 0.45, 95% CI = 0.28-0.72) and more likely to present with unexplained falls (OR 2.33, 95% CI = 1.36-4.32). The typical provoking factors of prolonged standing (OR 0.55, 95% CI = 0.40-0.72), posture change (OR 0.61, 95% CI = 0.46-0.82) and hot environments (OR 0.57, 95% CI = 0.42-0.78) were also less common in older patients. Conclusion: in our large study population, VVS was more common in older patients. The clinical presentation differed significantly between the two groups. Older patients were less likely to give a typical history and therefore clinicians need to have a high index of suspicion when evaluating the older patient presenting with collapse or unexplained falls.
Author(s): Duncan GW, Tan MP, Newton JL, Reeve P, Parry SW
Publication type: Article
Publication status: Published
Journal: Age and Ageing
Print publication date: 05/05/2010
ISSN (print): 0002-0729
ISSN (electronic): 1468-2834
Publisher: Oxford University Press
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