Reduced cerebral autoregulation as the genesis of symptoms in orthostatic intolerance in elderly (1069.3)

Abstract

Background: The prevalence of orthostatic hypotension (OH) increases with age and affects over 50% of elderly visiting a falls and syncope outpatient clinic. OH may be symptomatic or asymptomatic. Surprisingly little is known why serious symptoms as dizziness, falling and syncope occur. A possible cause of symptom development may be cerebral hypoperfusion due to loss of cerebral autoregulation (CA). The purpose of this study is to compare CA in elderly with symptomatic and asymptomatic OH and a control group without OH.Methods: Dynamic CA is assessed in 20 elderly with symptomatic OH, 20 with asymptomatic OH and 20 age‐matched healthy subjects without OH using transfer function analysis (TFA) on blood pressure (BP) and cerebral blood flow velocity (CBFV). Single supine to standing measurements is used to assess time domain changes in BP, CBFV and heart rate. Patient inclusion continues until March 2014.Results: TFA provides outputs gain and phase of the relation between BP and CBFV to assess CA. Time domain analyses will be used to report time to peak and nadir, and time and amount of recovery.Conclusions : This study characterizes CA in symptomatic and asymptomatic OH. The yet preliminary conclusion is that a reduced CA performance is related to the subject group with symptomatic OH in comparison to the asymptomatic OH group.