Abstract
Background
Antihypertensive therapy is associated with significant relative risk reductions in
the incidence of heart failure, myocardial infarction, and stroke. However, a common
adverse reaction to antihypertensive therapy is orthostatic hypotension, dehydration,
and syncope. We propose that continued use of antihypertensive medications at the
same dosage during the dry summer months in patients living in the Sonoran desert
leads to an increase in syncopal episodes.
Methods
All hypertensive patients who were treated with medications and admitted with International
Classification of Diseases, 9th Revision code diagnosis of syncope were included.
They were defined as “cases” if they presented during the summer months (May to September
2012) and “controls” if they presented during the winter months (November 2012 to
March 2013). The primary outcome measure was the presence of clinical dehydration.
The statistical significance was determined using the 2-sided Fisher exact test.
Results
A total of 496 patients with an International Classification of Diseases, 9th Revision
code diagnosis of syncope were screened, and 179 patients were included in the final
analysis. In patients taking antihypertensive medications, there were a significantly
higher number of cases of syncope secondary to dehydration or orthostatic hypotension
during the summer months (45%) compared with the winter months (26%) (P = .01). The incidence of syncope was significantly higher in older patients (63%)
compared with younger individuals (37%) during the summer months.
Conclusions
The incidence of syncope increases during the summer months among people who reside
in a dry desert climate and who are taking antihypertensive medications. On the basis
of our findings, we describe an easily preventable condition that we define as the
“Summer Syncope Syndrome.” We recommend judicious reduction of antihypertensive therapy
in patients residing in a hot and dry climate, particularly during the summer months.
Keywords
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Article Info
Publication History
Published online: March 10, 2014
Footnotes
Funding: None.
Conflict of Interest: None.
Authorship: All authors had access to the data and played a role in writing this manuscript.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Summer Syncope Syndrome: Spuriously Studied?The American Journal of MedicineVol. 127Issue 9
- PreviewGiven the health burden of syncope,1 the innovative efforts made by Huang et al2 in establishing the possible association between antihypertensive medications and summer syncopal episodes are to be congratulated. However, we believe that the authors have drawn spurious associations raising severe concerns on the validity of the findings.
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