Response to Lifestyle Modification in Patients With Vasovagal Syncope and Hypertension Relative to the Patients With Vasovagal Syncope and Normal Blood Pressure

Background: Neurally-mediated (vasovagal) syncope refers to a reflex response causing vasodilatation and/or bradycardia leading to systemic hypotension and cerebral hypoperfusion. Patients should be encouraged to liberalize their fluid and salt intake, unless they have contraindications such as poor control hypertension. Objectives: In this study, we evaluated response to treatment (lifestyle modification) of patients with vasovagal syncope and hyper- tension relative to the patients with vasovagal syncope and normal blood pressure. Methods: We reviewed the medical records of patients referred to the syncope clinic of Rajaie heart center in Tehran, Iran, between 2007 and 2010.we included patients with vasovagal syncope and excluded patients with other causes of syncope like cardiac, cere- brovascular accident and head trauma. Patients were followed 29.15 + 10.43 months. Patients were treated with lifestyle modifica- tion, salt and water intake and 30 minute isotonic exercise 5 days a week. Results: From a total of 235 studied patients, 161cases (68.5%) were males. The mean age of the patients was 48.01 + 19.66 years. Sixty-four patients (27.2%) were hypertensive. Response to treatment was defined as no syncope in the follow-up period. There was a significant dierence in response to treatment between patients with vasovagal syncope and hypertension and patients with vaso- vagal syncope and normal blood pressure (P = 0.000). The mean syncope rate was higher in hypertensive patients before and after the treatment and hypertensive patients were older (P = 0.000). Conclusions: Response to treatment was better in vasovagal patients with normal blood pressure compared to those who are hy- pertensive but hypertensive patients responded too.