December 1, 1989Archives of Internal Medicine
Reduced Susceptibility to Syncope During Postural Tilt in Old Age
Key result
Presyncopal vasovagal symptoms during head-up tilt were less common in older subjects compared to young subjects, and intravenous propranolol did not prevent the vasovagal reaction.
Why the study?
Does old age or beta-adrenergic blockade affect the susceptibility to vasovagal syncope during postural tilt?
Population
Healthy young and old subjects (Study 1: 9 young, 22 old; Study 2: 11 young, 10 old)
Comparison
Head-up tilt testing; intravenous propranolol… vs Old vs young subjects; propranolol vs saline
Design
Cohort, 11 healthy young subjects randomized to receive intravenous…
Authors
Discussion
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Implication
Fewer tilt-induced vasovagal symptoms in older adults may indicate age-related protection; hypothesis-generating for autonomic mechanisms and needs prospective confirmation.
Study Design
Type
RCT (n=52)
Randomization
randomized
Structured PICO
Does old age or beta-adrenergic blockade affect the susceptibility to vasovagal syncope during postural tilt?
P
Population
52 healthy young and older subjects evaluated across two studies to assess responses to head-up tilt and the effects of intravenous propranolol.
I
Intervention
Head-up tilt testing; intravenous propranolol hydrochloride or saline in young subjects
C
Comparator
Old vs young subjects; propranolol vs saline
O
Outcome
Occurrence of presyncopal vasovagal symptoms during head-up tiltsurrogate
Older age is associated with a reduced susceptibility to vasovagal presyncope during postural tilt, which is not explained by decreased beta-adrenergic responsiveness.
Cite This Study
Lewis A. Lipsitz (1989) conducted an RCT in Vasovagal syncope (n=52). Intravenous propranolol hydrochloride vs. Saline and young subjects was evaluated on Presyncopal vasovagal symptoms during head-up tilt. Presyncopal vasovagal symptoms during head-up tilt were less common in older subjects compared to young subjects, and intravenous propranolol did not prevent the vasovagal reaction.