nach oben

Clinical Autonomic Research

Erschienen in:

01.08.2010 | Research Article

Comorbid health conditions in women with syncope

verfasst von: Umit H. Ulas, Thomas C. Chelimsky, Gisela Chelimsky, Aditya Mandawat, Kevin McNeeley, Amer Alshekhlee

Erschienen in: Clinical Autonomic Research | Ausgabe 4/2010

Einloggen, um Zugang zu erhalten

Abstract

Objective

We determine the comorbid conditions associated with syncope in women. In addition, we hypothesize a higher proportion of autonomic comorbid conditions during the female reproductive age.

Methods

We identified a cohort of patients admitted to US hospitals with the principal diagnosis of syncope. We compare patient demographics stratified by gender as well as syncope associated comorbidities. We compared these comorbidities in female of reproductive age (15–45) to men as control.

Results

From a total sample of 305,932, females constituted 56.7% (n = 173,434). Females were slightly older (mean age 70.9 ± 17.9 vs. 66.7 ± 17.3; P < 0.0001); with similar racial distribution (white 57.8 vs. 57.5%), and similar length of hospital stay (mean 2.66 ± 2.63 vs. 2.68 ± 2.72 days; P > 0.05). Females had higher proportion of migraine (1.65 vs. 1.29%; odds ratio ‘OR’ 1.29; 95% confidence interval ‘CI’ 1.21, 1.36); chronic fatigue syndrome (1.73 vs. 1.3%; OR 1.32; 95% CI 1.25, 1.4); gastroparesis (0.2 vs. 0.12%; OR 1.64; 95% CI 1.35, 1.98); interstitial cystitis (0.07 vs. 0.01%; OR 7.44; 95% CI 4.10, 13.5); and postural tachycardia syndrome (0.49 vs. 0.44%; OR 1.1; 95% CI 1.001, 1.23). Orthostatic hypotension was not different between the groups (P = 0.24). When the sample was stratified by age category, the odds ratio for gastroparesis, orthostatic hypotension, and postural tachycardia syndrome was increased (P < 0.05).

Interpretation

A higher proportion of autonomic dysfunction was present in women compared to men. In addition, these comorbid autonomic conditions were especially prominent during the female reproductive age.

Acton KJ, Burrows NR, Wang J, Thompson T (2006) Diagnosed diabetes among American Indians and Alaska Natives aged <35 years-United States, 1994–2004. MMWR Morb Mortal Wkly Rep 55:1201–1203

Al-Shekhlee A, Lindenberg JR, Hachwi RN, Chelimsky TC (2005) The value of autonomic testing in postural tachycardia syndrome. Clin Auton Res 15(3):219–222CrossRefPubMed

Alshekhlee A, Shen W, Mackall J, Chelimsky TC (2009) Incidence and mortality rates of syncope in the United States. Am J Med 122(2):181–188CrossRefPubMed

Benditt DG, van Dijk JG, Sutton R, Wieling W, Lin JC, Sakaguchi S, Lu F (2004) Syncope. Curr Probl Cardiol 29(4):152–229CrossRefPubMed

Bousser MG (2004) Estrogens, migraine, and stroke. Stroke 35(11 Suppl 1):2652–2656CrossRefPubMed

Brandes JL (2006) The influence of estrogen on migraine: a systematic review. JAMA 295(15):1824–1830CrossRefPubMed

Carter JR, Lawrence JE, Klein JC (2009) Menstrual cycle alters sympathetic neural responses to orthostatic stress in young, eumenorrheic women. Am J Physiol Endocrinol Metab 297(1):85–91CrossRef

Centers for Disease Control and Prevention (2006) Chronic Fatigue Syndrome. “http://www.cdc.gov/cfs”

Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383CrossRefPubMed

10.

Chelimsky TC, Chelimsky GG (2007) Autonomic abnormalities in cyclic vomiting syndrome. J Pediatr Gastroenterol Nutr 44(3):326–330CrossRefPubMed

11.

Convertino VA (1998) Gender differences in autonomic functions associated with blood pressure regulation. Am J Physiol 275(6 Pt 2):1909–1920

12.

Cowie CC, Rust KF, Byrd-Holt DD, Eberhardt MS, Flegal KM, Engelgau MM, Saydah SH, Williams DE, Geiss LS, Gregg EW (2006) Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population: National Health and Nutrition Examination Survey 1999–2002. Diabetes Care 29(6):1263–1268CrossRefPubMed

13.

Daas A, Mimouni-Bloch A, Rosenthal S, Shuper A (2009) Familial vasovagal syncope associated with migraine. Pediatr Neurol 40(1):27–30CrossRefPubMed

14.

Fu Q, Arbab-Zadeh A, Perhonen MA, Zhang R, Zuckerman JH, Levine BD (2004) Hemodynamics of orthostatic intolerance: implications for gender differences. Am J Physiol Heart Circ Physiol 286(1):449–457CrossRef

15.

Gallagher AM, Thomas JM, Hamilton WT, White PD (2004) Incidence of fatigue symptoms and diagnoses presenting in UK primary care from 1990 to 2001. J R Soc Med 97(12):571–575CrossRefPubMed

16.

Griffith JP, Zarrouf FA (2008) A systematic review of chronic fatigue syndrome: don’t assume it’s depression. Prim care companion. J Clin Psychiatry 10(2):120–128

17.

Grubb BP (2005) Clinical practice. Neurocardiogenic syncope. N Engl J Med 352(10):1004–1010CrossRefPubMed

18.

Grubb BP, Kanjwal Y, Kosinski DJ (2006) The postural tachycardia syndrome: a concise guide to diagnosis and management. J Cardiovasc Electrophysiol 17(1):108–112PubMed

19.

Kanjwal MY, Kosinski DJ, Grubb BP (2003) Treatment of postural orthostatic tachycardia syndrome and inappropriate sinus tachycardia. Curr Cardiol Rep 5(5):402–406CrossRefPubMed

20.

Kanjwal K, Karabin B, Kanjwal Y, Grubb BP (2009) Outcomes of pregnancy in patients with preexisting postural tachycardia syndrome. Pacing Clin Electrophysiol 32(8):1000–1003CrossRefPubMed

21.

Klein CM (2008) Evaluation and management of autonomic nervous system disorders. Semin Neurol 28(2):195–204CrossRefPubMed

22.

Liese AD, D’Agostino RB Jr, Hamman RF, Kilgo PD, Lawrence JM, Liu LL, Loots B, Linder B, Marcovina S, Rodriguez B, Standiford D, Williams DE (2006) The burden of diabetes mellitus among US youth: prevalence estimates from the SEARCH for diabetes in youth study. Pediatrics 118(4):1510–1518CrossRefPubMed

23.

Lutgendorf SK, Latini JM, Rothrock N, Zimmerman MB, Kreder KJ Jr (2004) Autonomic response to stress in interstitial cystitis. J Urol 172(1):227–231CrossRefPubMed

24.

Martin VT, Behbehani M (2006) Ovarian hormones and migraine headache: understanding mechanisms and pathogenesis—part 2. Headache 46(1):365–386CrossRefPubMed

25.

Miller VM, Ducles SP (2008) Vascular actions of estrogens: functional implications. Pharmacol Rev 60(2):210–241CrossRefPubMed

26.

Mouracade P, Lang H, Jacqmin D, Saussine C (2008) Using the interstitial cystitis new diagnostic criteria in daily practice: about 156 patients. Prog Urol 18(10):674–677CrossRefPubMed

27.

Newton JL, Okonkwo O, Sutcliffe K, Seth A, Shin J, Jones DE (2007) Symptoms of autonomic dysfunction in chronic fatigue syndrome. QJM 100(8):519–526CrossRefPubMed

28.

Patrick A, Epstein O (2008) Review article: gastroparesis. Aliment Pharmacol Ther 27(9):724–740PubMedCrossRef

29.

Piovesan EJ, Sobreira CF, Scola RH, Lorenzoni PJ, Lange MC, Werneck LC, Smith D, Silberstein S (2008) Episodic migraine associated with postural orthostatic tachycardia syndrome and vasovagal syncope: migraine triggers neuromediated syncope. Arq Neuropsiquiatr 66(1):77–79PubMed

30.

Shin C, Abbott RD, Lee H, Kim J, Kimm K (2004) Prevalence and correlates of orthostatic hypotension in middle-aged men and women in Korea: the Korean Health and Genome Study. J Hum Hypertens 18(10):717–723CrossRefPubMed

31.

Verwoert GC, Mattace-Raso FU, Hofman A, Heeringa J, Stricker BH, Breteler MM, Witteman JC (2008) Orthostatic hypotension and risk of cardiovascular disease in elderly people: the Rotterdam study. J Am Geriatr Soc 56(10):1816–1820CrossRefPubMed

32.

Wessman M, Kaunisto MA, Kallela M, Palotie A (2004) The molecular genetics of migraine. Ann Med 36(6):462–473CrossRefPubMed

Titel: Comorbid health conditions in women with syncope
verfasst von: Umit H. Ulas
Thomas C. Chelimsky
Gisela Chelimsky
Aditya Mandawat
Kevin McNeeley
Amer Alshekhlee
Publikationsdatum: 01.08.2010
Verlag: Springer-Verlag
Erschienen in: Clinical Autonomic Research / Ausgabe 4/2010
Print ISSN: 0959-9851
Elektronische ISSN: 1619-1560
DOI: https://doi.org/10.1007/s10286-010-0070-x

Neu in den Fachgebieten Neurologie und Psychiatrie

Nicht Creutzfeldt Jakob, sondern Abführtee-Vergiftung

29.05.2024 Obstipation Nachrichten

Eine ältere Frau trinkt regelmäßig Sennesblättertee gegen ihre Verstopfung. Der scheint plötzlich gut zu wirken. Auf Durchfall und Erbrechen folgt allerdings eine Hyponatriämie. Nach deren Korrektur kommt es plötzlich zu progredienten Kognitions- und Verhaltensstörungen.

Hörschwäche erhöht Demenzrisiko unabhängig von Beta-Amyloid

29.05.2024 Hörstörungen Nachrichten

Hört jemand im Alter schlecht, nimmt das Hirn- und Hippocampusvolumen besonders schnell ab, was auch mit einem beschleunigten kognitiven Abbau einhergeht. Und diese Prozesse scheinen sich unabhängig von der Amyloidablagerung zu ereignen.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Comorbid health conditions in women with syncope