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Prevalence and complications of orthostatic dizziness in the general population

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Abstract

Although orthostatic dizziness (OD) is a common complaint, its prevalence and medical impact in the general population are unknown. The study aims to assess prevalence, medical sequelae and healthcare and social impact of OD in the general population. Participants of the representative German National Health Interview Survey 2003 (n = 4077, age 18–89 years, response rate 52%) were screened for moderate or severe dizziness or vertigo. As part of a larger study on the epidemiology of dizziness and vertigo, a consecutive subsample of screen-positive participants (n = 825) underwent a structured medical interview for OD based on the criteria: (1) non-vestibular dizziness (i.e. diffuse non-rotational dizziness, light headedness, feeling of impeding faint), (2) provocation by sudden postural change (i.e. standing up from supine or sitting), (3) duration of seconds to several minutes, (4) absence of vestibular vertigo according to a validated neurotologic interview. The 12-month prevalence of OD was 10.9% (women 13.1%, men 8.2%), lifetime prevalence was 12.5% (women 15.0%, men 9.6%). OD accounted for 42% of all participants with dizziness/vertigo and for 55% of non-vestibular dizziness diagnoses. The prevalence of OD was highest in young people, although the proportion with severe OD steadily increased with age. OD led to syncope in 19%, falls in 17% and traumatic injury in 5% of affected subjects. Almost half of the individuals with OD (45%) had consulted a physician and 4% had been treated in hospital. OD is a frequent cause of non-vestibular dizziness for which patients often seek medical advice. It carries a considerable risk of syncope, falls and traumatic injury.

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References

  1. Ensrud KE, Nevitt MC, Yunis C, Hulley SB, Grimm RH, Cummings SR, for the Study of Osteoporotic Fractures Research Group (1992) Postural hypotension and postural dizziness in elderly women: the study of osteoporotic fractures. Arch Intern Med 152:1058–1064

    Article  PubMed  CAS  Google Scholar 

  2. Consensus Committee of the American Autonomic Society and the American Academy of Neurology (1996) Consensus statement on the definition of orthostatic hypotention, pure autonomic failure and multiple system atrophy. Neurology 46:1470

    Google Scholar 

  3. Wieling W, Krediet CTP, van Dijk N, Linzer M, Tschakovsky ME (2007) Initial orthostatic hypotension: review of a forgotten condition. Clin Sci 112:157–165

    Article  PubMed  Google Scholar 

  4. Ward C, Kenny RA (1996) Reproducibility of orthostatic hypotension in symptomatic elderly. Am J Med 100:418–422

    Article  PubMed  CAS  Google Scholar 

  5. Weiss A, Grossmann E, Beloosesky Y, Grinblat J (2002) Orthostatic hypotension in an acute geriatric ward. Arch Intern Med 162:2369–2374

    Article  PubMed  Google Scholar 

  6. Ooi WL, Barett S, Hossain M, Kelley-Gagnon M, Lipsitz LA (1997) Patterns of orthostatic blood pressure change and their clinical correlates in a frail, elderly population. JAMA 277:1299–1304

    Article  PubMed  CAS  Google Scholar 

  7. Wu J, Yang Y, Lu F, Wu C, Chang C (2008) Population-based study on the prevalence and correlates of orthostatic hypotension/hypertension and orthostatic dizziness. Hypertens Res 31:897–904

    Article  PubMed  Google Scholar 

  8. Rutan GH, Hermanson B, Bild DE, Kittner SJ, LaBaw F, Tell GS, for the CHS Collaborative Research Group (1992) Orthostatic hypotension in older adults. Cardiovasc Health Study Hypertens 19:508–519

    CAS  Google Scholar 

  9. Mader S, Josephson K, Rubenstein L (1987) Low prevalence of postural hypotension among community-dwelling elderly. JAMA 258:1511–1514

    Article  PubMed  CAS  Google Scholar 

  10. Tinetti ME, Speechley M, Ginter SF (1988) Risk factors for falls among elderly persons living in the community. N Engl J Med 319:1701–1707

    Article  PubMed  CAS  Google Scholar 

  11. Liu BA, Topper AK, Reeves RA, Gryfe C, Maki E (1995) Falls among older people: relationship to medication use and orthostatic hypotension. J Am Geriatr Soc 43:1141–1145

    PubMed  CAS  Google Scholar 

  12. Ooi WL, Hossain M, Lipsitz LA (2000) The association between orthostatic hypotension and recurrent falls in nursing home residents. Am J Med 108:106–111

    Article  PubMed  CAS  Google Scholar 

  13. Heitterachi E, Lord S, Meyerkort P, Mc Closkey I, Fitzpatrick R (2002) Blood pressure changes on upright predict falls in older people. Age Ageing 31:181–186

    Article  PubMed  Google Scholar 

  14. Masaki K, Schatz I, Burchfiel C et al (1998) Orthostatic hypotension predicts mortality in elderly men: the Honolulu Heart Program. Circulation 98:2290–2295

    PubMed  CAS  Google Scholar 

  15. Luukinen H, Koski K, Laippala P, Airaksinen K (2004) Orthostatic hypotension and the risk of myocardial infarction in the home-dwelling elderly. J Intern Med 255:486–493

    Article  PubMed  CAS  Google Scholar 

  16. Eigenbrodt M, Rose K, Couper D, Arnett D, Smith R, Jones D (2000) Orthostatic hypotension as a risk factor for stroke: the Artherosclerosis Risk in Communities (ARIC) study, 1987–1996. Stroke 31:2307–2313

    PubMed  CAS  Google Scholar 

  17. Luukinen H, Koski K, Laippala P, Kivelä S (1999) Prognosis of diastolic and systolic orthostatic hypotension in older persons. Arch Intern Med 159:273–280

    Article  PubMed  CAS  Google Scholar 

  18. Räihä I, Luutonen S, Piha J, Seppänen A, Toikka T, Sourander L (1995) Prevalence, predisposing factors and prognostic importance of postural hypotension. Arch Int Med 155:930–935

    Article  Google Scholar 

  19. Shin C, Abbott R, 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 18:717–723

    Article  PubMed  CAS  Google Scholar 

  20. Tilvis R, Hakala S, Valvanne J, Erkinjunntti T (1996) Postural hypotension and dizziness in a general aged population: a four-year follow-up of the Helsinki Aging Study. J Am Geriatr Soc 44:809–814

    PubMed  CAS  Google Scholar 

  21. Neuhauser H, von Brevern M, Radtke A et al (2005) Epidemiology of vestibular vertigo—a neurotologic survey of the general population. Neurology 65:898–904

    Article  PubMed  CAS  Google Scholar 

  22. Wilson EB (1927) Probable inference, the law of succession, and statistical inference. J Am Stat Assoc 22:209–212

    Article  Google Scholar 

  23. Neuhauser H, Leopold M, von Brevern M, Arnold G, Lempert T (2001) The interrelations of migraine, vertigo, and migrainous vertigo. Neurology 56:436–441

    PubMed  CAS  Google Scholar 

  24. Radtke A, Lempert T, Gresty MA, Brookes GB, Bronstein AM, Neuhauser H (2002) Migraine and Meniere’s disease: is there a link? Neurology 59:1700–1704

    PubMed  CAS  Google Scholar 

  25. Ishiyama A, Jacobson KM, Baloh RW (2000) Migraine and benign positional vertigo. Ann Otol Rhinol Laryngol 109:377–380

    PubMed  CAS  Google Scholar 

  26. Thijs RD, Kruit MC, van Buchem MA (2006) Syncope in migraine: the population-based CAMERA study. Neurology 66:1034–1037

    Article  PubMed  CAS  Google Scholar 

  27. Neuhauser HK, von Brevern M, Radtke A et al (2005) Epidemiology of vestibular vertigo—a neurotologic survey of the general population. Neurology 65:898–904

    Article  PubMed  CAS  Google Scholar 

  28. Cummings S, Nevitt M, Kidd S (1988) Forgetting falls: the limited accuracy of recall of falls in the elderly. J Am Geriatr Soc 36:613–616

    PubMed  CAS  Google Scholar 

  29. Yardley L, Owen N, Nazareth I, Luxon L (1998) Prevalence and presentation of dizziness in a general practice community sample of working age people. Br J Gen Pract 48:1131–1135

    PubMed  CAS  Google Scholar 

  30. de Marées H (1976) Zur orthostatischen Sofortregulation. Cardiology 61:78–90

    Article  PubMed  Google Scholar 

  31. Nozawa I, Imamura S, Hashimoto K, Nakayama H, Murakami Y (1997) The relationship between orthostatic dizziness and hypotension in male medical students. Auris Nasus Larynx 24:53–58

    Article  PubMed  CAS  Google Scholar 

  32. Nozawa I, Hisamatsu K, Imamura S, Sufimor I, Nakayama H, Murakami Y (1996) Study on orthostatic dysregulation and the Shellong test in healthy young females. ORL J Otorhinolaryngol Relat Spec 58:110–114

    Article  PubMed  CAS  Google Scholar 

  33. Colledge N, Wilson J, Macintyre C, MacLennen W (1994) The prevalence and characteristics of dizziness in an elderly community. Age Ageing 23:117–120

    Article  PubMed  CAS  Google Scholar 

  34. Soteriades E, Evans J, Larson M et al (2002) Incidence and prognosis of syncope. N Engl J Med 347:878–885

    Article  PubMed  Google Scholar 

  35. Hannaford P, Simpson J, Bisset A, Davis A, McKerrow W, Mills R (2005) The prevalence of ear, nose and throat problems in the community: results from a national cross-sectional postal survey in Scotland. Fam Pract 22:227–233

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We gratefully acknowledge the funding of the GNT-HIS by the German Ministry of Health. There is no conflict of interests for any of the authors.

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Authors and Affiliations

  1. Department of Neurology, Charité Campus Virchow Klinikum, Augustenburger platz 1, 13353, Berlin, Germany

    Andrea Radtke

  2. Department of Neurology, Schlosspark-Klinik, Berlin, Germany

    Thomas Lempert

  3. Department of Neurology, Park-Klinik Weissensee, Berlin, Germany

    Michael von Brevern

  4. Department of Clinical and Experimental Epilepsy, University College London Institute of Neurology, London, UK

    Maria Feldmann

  5. Center for Vestibular and Oculomotor Disorders, Ludwig Maximilians-Universität, Muenchen, Germany

    Franziska Lezius

  6. Department of Epidemiology, Robert Koch Institute, Berlin, Germany

    Hannelore Neuhauser

Authors
  1. Andrea Radtke
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  2. Thomas Lempert
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  3. Michael von Brevern
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  4. Maria Feldmann
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  5. Franziska Lezius
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  6. Hannelore Neuhauser
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Correspondence to Andrea Radtke.

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Radtke, A., Lempert, T., von Brevern, M. et al. Prevalence and complications of orthostatic dizziness in the general population. Clin Auton Res 21, 161–168 (2011). https://doi.org/10.1007/s10286-010-0114-2

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  • DOI: https://doi.org/10.1007/s10286-010-0114-2

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