Document Detail


Nonspecific dizziness: frequency of supine hypertension associated with hypotensive reactions on head-up tilt.
MedLine Citation:
PMID:  16239900     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The clinical syndrome of supine hypertension associated with orthostatic hypotension (OH) in given individuals is recognized by specialists, but is underdiagnosed in the community. The objective of this study was to assess supine hypertension associated with hypotensive reactions on head-up tilt (SH-HRT) among patients evaluated for nonspecific dizziness. Consecutive patients with nonspecific dizziness were studied with a 10-min supine 30-min head-up tilt test. Supine hypertension (SH) was diagnosed when supine systolic blood pressure (SBP) was > or = 140 mmHg and/or supine diastolic blood pressure (DBP) was > or = 90 mmHg. Hypotensive reactions on tilt (HRT) were diagnosed when SBP decreased by > or = 30 mmHg on tilt and/or DBP decreased by > or = 15 mmHg. Of 430 patients tested, 42 (9.8%) had SH-HRT. The median age was 67 years; 37 had a pretest diagnosis of hypertension, with treatment. The median supine BP was 162/90 mmHg; the median nadir BP on tilt was 118/78 mmHg. Four SH-HRT patterns were recognized: (I) SH with typical neurogenic OH (n = 6), (II) SH with vasovagal reaction on tilt (n = 4), (III) SH with sustained HRT (n = 28), and (IV) SH with mixed orthostatic-vasovagal reaction on tilt (n = 4). Dizziness on tilt occurred in 25% of patients category III (SH with sustained HRT), while appearing universally in other SH-HRT patterns. In conclusion, nonspecific dizziness may be the chief complaint in patients with SH-HRT, a disorder often unrecognized by clinicians. Different patterns of SH-HRT on HUTT may reflect different aberrations in cardiovascular homeostasis and may require differentiated management strategies.
Authors:
J E Naschitz; R Mussafia-Priselac; Y Kovalev; N Zaigraykina; G Slobodin; N Elias; S Storch; I Rosner
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of human hypertension     Volume:  20     ISSN:  0950-9240     ISO Abbreviation:  J Hum Hypertens     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-01-19     Completed Date:  2006-04-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8811625     Medline TA:  J Hum Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  157-62     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine A, The Bnai-Zion Medical Center and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. Naschitz@tx.technion.ac.il
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Blood Pressure / physiology*
Dizziness / complications,  physiopathology*
Female
Humans
Hypertension / complications*
Hypotension, Orthostatic / complications*
Male
Middle Aged
Retrospective Studies
Supine Position / physiology
Syncope, Vasovagal / physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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