Key result
Orthostatic hypotension accounts for 46% of new-onset syncope in patients over 50 undergoing tilt testing.
Why the study?
Syncope onset after age 50 is uncommon, and finding a definitive diagnosis can be difficult given the multiplicity of interacting factors.
Observational (n=52)
No
In patients over 50 presenting with new-onset syncope, orthostatic hypotension is the most common cause, requiring careful medication review and comprehensive evaluation.
Suggests orthostatic hypotension assessment in new syncope over 50; leaves open validation beyond case reports.
It is not common to start suffering from syncopes after age 50. They are mainly male patients who present causes other than vasovagal syncope, which predominates at an early age. Orthostatic hypotension is the predominant causal factor, which is attributed in many cases to advanced age, metabolic, cardiovascular or neurological diseases, to failure of baroreflexes, all of the above may be associated with the use of hypotensive drugs alone or in combination with psychotropic drugs. Furthermore, causes such as carotid sinus syncope, postprandial syncope and situational syncope become more frequent. Therefore, as people age, they present a favorable pathological terrain for the production of syncope. The older you are, the more likely you are to start with syncope. Finding the definitive diagnosis for their syncopes can be difficult, given the multiplicity of interacting factors. Their study is more exhaustive and requires a good anamnesis, knowing the drugs used by the patient, concomitant diseases and careful surveillance to get closer to the diagnosis.
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Jiménez-Cohl et al. (2020) conducted an observational in Syncope beginning at 50 years or older (n=52). Head-up tilt (HUT) test was evaluated on Positive Head-Up Tilt (HUT) test. In patients over 50 years old presenting with new-onset syncope, orthostatic hypotension was the most frequent cause identified during head-up tilt testing, accounting for 46% of cases.
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