A three-group comparison of acute-onset dizzy, long-term dizzy and non-dizzy older patients in primary care

Abstract

The hypothesis of increased cardiovascular risk contributing to chronic dizziness has been discussed controversially so far. We investigated older patients suffering from acute (<6 months), chronic (≥ 6 months) or no dizziness, in terms of their cardiovascular risk and other impairments. A cross-sectional three-group comparison of 257 patients (65+) presenting at family medicine surgeries in Germany was performed. Measures of cardiovascular risk, including overall scores, scores of quality of life (SF-12), activities of daily living (ADL), depression (GDS), dizziness handicap (DHI) and patients' needs (DiNA), as well as comorbidity and medication, were compared in univariate and multivariate logistic regression analysis. In univariate analysis, systolic and diastolic blood pressure were significantly lower in the dizziness groups. The overall cardiovascular risk was not increased in dizzy patients. Anxiety was strongly associated with dizziness, whereas other associations were of marginal importance. In multivariate analysis, age (OR 1.10, 95% CI 1.03-1.17), female gender (OR 2.07, 95% CI 1.01-4.26) and anxiety (OR 2.50, 95% CI 1.03-6.05) were associated with acute dizziness, whereas only female gender was significant in chronic dizziness (OR 1.96, 95% CI 1.02- 3.75). Comparing all dizzy patients with the non-dizzy group, lower systolic blood pressure was also significantly associated with dizziness. Results from our sample suggest that low systolic blood pressure is more important for dizziness in older patients than increased cardiovascular risk. Acute-onset and long-term dizzy patients were comparable in many aspects, which makes this classification less clinically important.