Summer Syncope Syndrome Redux - 18/09/15
, Chirag Desai, MD a, Nirmal Singh, MD a, Natasha Sharda, MD a, Aaron Fernandes, MD a, Irbaz Bin Riaz, MD a, Joseph S. Alpert, MD bAbstract |
Background |
While antihypertensive therapy is known to reduce the risk for heart failure, myocardial infarction, and stroke, it can often cause orthostatic hypotension and syncope, especially in the setting of polypharmacy and possibly, a hot and dry climate. The objective of the present study was to investigate whether the results of our prior study involving continued use of antihypertensive drugs at the same dosage in the summer as in the winter months for patients living in the Sonoran desert resulted in an increase in syncopal episodes during the hot summer months.
Methods |
All hypertensive patients who were treated with medications and admitted with International Classification of Diseases, 9th Revision code diagnosis of syncope were included. This is a 3-year retrospective chart review study. They were defined as “cases” if they presented during the summer months (May to September) and “controls” if they presented during the winter months (November to March). The primary outcome measure was the presence of clinical dehydration. The statistical significance was determined using the 2-sided Fisher's exact test.
Results |
A total of 834 patients with an International Classification of Diseases, 9th Revision code diagnosis of syncope were screened: 477 in the summer months and 357 in the winter months. In patients taking antihypertensive medications, there was a significantly higher number of cases of syncope secondary to dehydration during the summer months (40.5%) compared with the winter months (29%) (P = .04). No difference was observed in the type of antihypertensive medication used and syncope rate. The number of antihypertensives used did not increase the cases of syncope in either summer or winter.
Conclusions |
An increased number of syncope events was observed in the summer months among people who reside in a dry desert climate and who are taking antihypertensive medications. The data confirm our earlier observations that demonstrated a greater number of cases of syncope among people who reside in a dry desert climate who were taking antihypertensive medications during summer months. We recommend judicious reduction of antihypertensive therapy in patients residing in a hot and dry climate, particularly during the summer months.
Le texte complet de cet article est disponible en PDF.Keywords : Heat syncope, Hypertension, Summer, Summer syncope
Plan
| Funding: None. |
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| Conflict of Interest: JA's conflict of interest statement is filed with The American Journal of Medicine and Elsevier, but it contains no implications whatsoever for the present study, which was done without any funding from any source and has no possible conflict of interest potential. All other authors have no conflict of interest to report. |
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| Authorship: All authors had access to the data and a role in writing the manuscript. JJH: Primary investigator, conception and design, integration of data, drafting of manuscript. CD: statistical analysis, integration of data, drafting of manuscript. NS: statistical analysis, integration of data, drafting of manuscript. NS: integration of data, drafting of manuscript. IBR: drafting of manuscript. JSA: Conception and design, drafting of manuscript, revising critically for important intellectual content. AF: Integration of data, drafting of manuscript. |
Vol 128 - N° 10
P. 1140-1143 - octobre 2015 Retour au numéro
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