Summer syncope syndrome redux

Jennifer Juxiang Huang, Chirag Desai, Nirmal Singh, Natasha Sharda, Aaron Fernandes, Irbaz Bin Riaz, Joseph S Alpert

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background While antihypertensive therapy is known to reduce the risk for heart failure, myocardial infarction, and stroke, it can often cause orthostatic hypotension and syncope, especially in the setting of polypharmacy and possibly, a hot and dry climate. The objective of the present study was to investigate whether the results of our prior study involving continued use of antihypertensive drugs at the same dosage in the summer as in the winter months for patients living in the Sonoran desert resulted in an increase in syncopal episodes during the hot summer months. Methods All hypertensive patients who were treated with medications and admitted with International Classification of Diseases, 9th Revision code diagnosis of syncope were included. This is a 3-year retrospective chart review study. They were defined as "cases" if they presented during the summer months (May to September) and "controls" if they presented during the winter months (November to March). The primary outcome measure was the presence of clinical dehydration. The statistical significance was determined using the 2-sided Fisher's exact test. Results A total of 834 patients with an International Classification of Diseases, 9th Revision code diagnosis of syncope were screened: 477 in the summer months and 357 in the winter months. In patients taking antihypertensive medications, there was a significantly higher number of cases of syncope secondary to dehydration during the summer months (40.5%) compared with the winter months (29%) (P =.04). No difference was observed in the type of antihypertensive medication used and syncope rate. The number of antihypertensives used did not increase the cases of syncope in either summer or winter. Conclusions An increased number of syncope events was observed in the summer months among people who reside in a dry desert climate and who are taking antihypertensive medications. The data confirm our earlier observations that demonstrated a greater number of cases of syncope among people who reside in a dry desert climate who were taking antihypertensive medications during summer months. We recommend judicious reduction of antihypertensive therapy in patients residing in a hot and dry climate, particularly during the summer months.

Original languageEnglish (US)
Pages (from-to)1140-1143
Number of pages4
JournalAmerican Journal of Medicine
Volume128
Issue number10
DOIs
StatePublished - Oct 1 2015

Fingerprint

Dexfenfluramine
Syncope
Antihypertensive Agents
Desert Climate
International Classification of Diseases
Climate
Dehydration
Polypharmacy
Orthostatic Hypotension
Heart Failure
Stroke
Myocardial Infarction
Outcome Assessment (Health Care)

Keywords

  • Heat syncope
  • Hypertension
  • Summer
  • Summer syncope

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Huang, J. J., Desai, C., Singh, N., Sharda, N., Fernandes, A., Riaz, I. B., & Alpert, J. S. (2015). Summer syncope syndrome redux. American Journal of Medicine, 128(10), 1140-1143. https://doi.org/10.1016/j.amjmed.2015.05.016

Summer syncope syndrome redux. / Huang, Jennifer Juxiang; Desai, Chirag; Singh, Nirmal; Sharda, Natasha; Fernandes, Aaron; Riaz, Irbaz Bin; Alpert, Joseph S.

In: American Journal of Medicine, Vol. 128, No. 10, 01.10.2015, p. 1140-1143.

Research output: Contribution to journalArticle

Huang, JJ, Desai, C, Singh, N, Sharda, N, Fernandes, A, Riaz, IB & Alpert, JS 2015, 'Summer syncope syndrome redux', American Journal of Medicine, vol. 128, no. 10, pp. 1140-1143. https://doi.org/10.1016/j.amjmed.2015.05.016
Huang JJ, Desai C, Singh N, Sharda N, Fernandes A, Riaz IB et al. Summer syncope syndrome redux. American Journal of Medicine. 2015 Oct 1;128(10):1140-1143. https://doi.org/10.1016/j.amjmed.2015.05.016
Huang, Jennifer Juxiang ; Desai, Chirag ; Singh, Nirmal ; Sharda, Natasha ; Fernandes, Aaron ; Riaz, Irbaz Bin ; Alpert, Joseph S. / Summer syncope syndrome redux. In: American Journal of Medicine. 2015 ; Vol. 128, No. 10. pp. 1140-1143.
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AB - Background While antihypertensive therapy is known to reduce the risk for heart failure, myocardial infarction, and stroke, it can often cause orthostatic hypotension and syncope, especially in the setting of polypharmacy and possibly, a hot and dry climate. The objective of the present study was to investigate whether the results of our prior study involving continued use of antihypertensive drugs at the same dosage in the summer as in the winter months for patients living in the Sonoran desert resulted in an increase in syncopal episodes during the hot summer months. Methods All hypertensive patients who were treated with medications and admitted with International Classification of Diseases, 9th Revision code diagnosis of syncope were included. This is a 3-year retrospective chart review study. They were defined as "cases" if they presented during the summer months (May to September) and "controls" if they presented during the winter months (November to March). The primary outcome measure was the presence of clinical dehydration. The statistical significance was determined using the 2-sided Fisher's exact test. Results A total of 834 patients with an International Classification of Diseases, 9th Revision code diagnosis of syncope were screened: 477 in the summer months and 357 in the winter months. In patients taking antihypertensive medications, there was a significantly higher number of cases of syncope secondary to dehydration during the summer months (40.5%) compared with the winter months (29%) (P =.04). No difference was observed in the type of antihypertensive medication used and syncope rate. The number of antihypertensives used did not increase the cases of syncope in either summer or winter. Conclusions An increased number of syncope events was observed in the summer months among people who reside in a dry desert climate and who are taking antihypertensive medications. The data confirm our earlier observations that demonstrated a greater number of cases of syncope among people who reside in a dry desert climate who were taking antihypertensive medications during summer months. We recommend judicious reduction of antihypertensive therapy in patients residing in a hot and dry climate, particularly during the summer months.

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