title: Carotid sinus hypersensitivity is common in patients presenting with hip fracture and unexplained falls.
abstract: BACKGROUND
  We tried to determine the prevalence of carotid sinus hypersensitivity (CSH) in patients with hip fractures with and without a clear history of an accidental fall.
  
  
  METHODS
  We studied 51 patients hospitalized for a hip fracture and 51 matched controls from our outpatients department. All patients were subjected to a carotid sinus massage in the supine and upright position. Patients were categorized in accidental (Group A) and unexplained (Group B) fallers.
  
  
  RESULTS
  Six of 33 (18.2%) patients in Group A and 12 of 18 (66.7%) patients in Group B (P < 0.001) had a positive response to the carotid sinus massage. Nine controls (17.6%) also demonstrated CSH. Patients in Group B were older (A: 75.5 +/- 8.5 years vs B: 80.1 +/- 5.9 years, P =0.029) and were more likely to have a history of unexplained falls or syncope in the past (A: 0% vs B: 66.7%, P < 0.0001) than individuals in group A. Vasodepressor/mixed forms accounted for the majority of CSH responses in Group B (75%). When compared with the control group, CSH was still more common in Group B (B: 66.7% vs control: 17.6%, P < 0.0001) but not in Group A (A: 18.2% vs control: 17.6%, P =1.000).
  
  
  CONCLUSIONS
  The prevalence of CSH is increased in elderly patients with hip fractures, only in those who present with an unexplained fall and report a history of syncope or unexplained falls in the past. The vasodepressor/mixed forms account for the majority of CSH responses in the group of unexplained fallers.
authors.affiliation: 2nd Department of Cardiology, Aristotle University, Hippocration Hospital, Thessaloniki, Greece. bsaxpe@yahoo.gr
authors.forename: Vasileios
authors.initials: V
authors.lastname: Sachpekidis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Vogiatzis
authors.forename: George
authors.initials: G
authors.lastname: Dadous
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kanonidis
authors.forename: Constantinos
authors.initials: C
authors.lastname: Papadopoulos
authors.forename: George
authors.initials: G
authors.lastname: Sakadamis
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006115:Greece / Q000453:epidemiology; D006336:Heart Massage / Q000706:statistics & numerical data; D006620:Hip Fractures / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D018570:Risk Assessment; D012307:Risk Factors; D013575:Syncope / Q000175:diagnosis* / Q000453:epidemiology*