Comorbid health conditions in women with syncope.
OBJECTIVE
We determine the comorbid conditions associated with syncope in women. In addition, we hypothesize a higher proportion of autonomic comorbid conditions during the female reproductive age.


METHODS
We identified a cohort of patients admitted to US hospitals with the principal diagnosis of syncope. We compare patient demographics stratified by gender as well as syncope associated comorbidities. We compared these comorbidities in female of reproductive age (15-45) to men as control.


RESULTS
From a total sample of 305,932, females constituted 56.7% (n = 173,434). Females were slightly older (mean age 70.9 +/- 17.9 vs. 66.7 +/- 17.3; P < 0.0001); with similar racial distribution (white 57.8 vs. 57.5%), and similar length of hospital stay (mean 2.66 +/- 2.63 vs. 2.68 +/- 2.72 days; P > 0.05). Females had higher proportion of migraine (1.65 vs. 1.29%; odds ratio 'OR' 1.29; 95% confidence interval 'CI' 1.21, 1.36); chronic fatigue syndrome (1.73 vs. 1.3%; OR 1.32; 95% CI 1.25, 1.4); gastroparesis (0.2 vs. 0.12%; OR 1.64; 95% CI 1.35, 1.98); interstitial cystitis (0.07 vs. 0.01%; OR 7.44; 95% CI 4.10, 13.5); and postural tachycardia syndrome (0.49 vs. 0.44%; OR 1.1; 95% CI 1.001, 1.23). Orthostatic hypotension was not different between the groups (P = 0.24). When the sample was stratified by age category, the odds ratio for gastroparesis, orthostatic hypotension, and postural tachycardia syndrome was increased (P < 0.05).


CONCLUSIONS
A higher proportion of autonomic dysfunction was present in women compared to men. In addition, these comorbid autonomic conditions were especially prominent during the female reproductive age.
Ulas
Umit H
UH
Autonomic Laboratory, Neurological Institute, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH 44106-5040, USA. Umit.Ulas@uhhospitals.org
Chelimsky
Thomas C
TC
Chelimsky
Gisela
G
Mandawat
Aditya
A
McNeeley
Kevin
K
Alshekhlee
Amer
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001342:Autonomic Nervous System Diseases / Q000145:classification / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D015897:Comorbidity; D015673:Fatigue Syndrome, Chronic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D044469:Racial Groups; D012737:Sex Factors; D013575:Syncope / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult
Curr Probl Cardiol. 2004 Apr;29(4):152-229
15107784
MMWR Morb Mortal Wkly Rep. 2006 Nov 10;55(44):1201-3
17093386
J Chronic Dis. 1987;40(5):373-83
3558716
Aliment Pharmacol Ther. 2008 May;27(9):724-40
18248660
JAMA. 2006 Apr 19;295(15):1824-30
16622144
Curr Cardiol Rep. 2003 Sep;5(5):402-6
12917056
Prim Care Companion J Clin Psychiatry. 2008;10(2):120-8
18458765
J R Soc Med. 2004 Dec;97(12):571-5
15574853
Pediatr Neurol. 2009 Jan;40(1):27-30
19068250
Prog Urol. 2008 Nov;18(10):674-7
18971112
Semin Neurol. 2008 Apr;28(2):195-204
18351521
N Engl J Med. 2005 Mar 10;352(10):1004-10
15758011
Ann Med. 2004;36(6):462-73
15513297
Am J Physiol Heart Circ Physiol. 2004 Jan;286(1):H449-57
14527942
Am J Med. 2009 Feb;122(2):181-8
19100958
Am J Physiol. 1998 Dec;275(6):R1909-20
9843880
Arq Neuropsiquiatr. 2008 Mar;66(1):77-9
18392420
J Pediatr Gastroenterol Nutr. 2007 Mar;44(3):326-30
17325552
Clin Auton Res. 2005 Jun;15(3):219-22
15944872
J Cardiovasc Electrophysiol. 2006 Jan;17(1):108-12
16426415
Pediatrics. 2006 Oct;118(4):1510-8
17015542
Stroke. 2004 Nov;35(11 Suppl 1):2652-6
15459439
Pacing Clin Electrophysiol. 2009 Aug;32(8):1000-3
19659618
J Hum Hypertens. 2004 Oct;18(10):717-23
15116144
Diabetes Care. 2006 Jun;29(6):1263-8
16732006
J Urol. 2004 Jul;172(1):227-31
15201780
QJM. 2007 Aug;100(8):519-26
17617647
J Am Geriatr Soc. 2008 Oct;56(10):1816-20
18795982
Am J Physiol Endocrinol Metab. 2009 Jul;297(1):E85-91
19401460
Headache. 2006 Mar;46(3):365-86
16618254
Pharmacol Rev. 2008 Jun;60(2):210-41
18579753