title: Postural tachycardia syndrome is associated with significant symptoms and functional impairment predominantly affecting young women: a UK perspective.
abstract: OBJECTIVE
  To examine a large UK cohort of patients with postural tachycardia syndrome (PoTS), to compare demographic characteristics, symptoms and treatment of PoTS at one centre compared to the largest patient group PoTS UK and to verify if their functional limitation is similar to patients with chronic fatigue syndrome (CFS).
  
  
  METHODS
  A cross-sectional study assessed the frequency of symptoms and their associated variables.
  
  
  METHODS
  Two PoTS cohorts were: (1) recruited via PoTS UK, (2) diagnosed at Newcastle Hospitals National Health Service (NHS) Foundation Trust 2009-2012. Patients with PoTS were then compared to a matched cohort with CFS.
  
  
  METHODS
  Patients' detailed demographics, time to diagnosis, education, disability, medications, comorbidity and precipitants. Symptom assessment tools captured, Fatigue Impact Scale, Epworth Sleepiness Scale, Orthostatic Grading Scale (OGS), Hospital Anxiety and Depression Scale, Health Assessment Questionnaire, Cognitive Failures Questionnaire.
  
  
  RESULTS
  136 patients with PoTS participated (84 members of PoTS UK (170 cohort; 50% return) and 52 (87 cohort; 60%) from Newcastle Clinics). The PoTS UK population was significantly younger than the clinic patients, with significantly fewer men (p=0.005). Over 60% had a university or postgraduate degree. Significantly more of the PoTS UK cohort were working, with hours worked being significantly higher (p=0.001). Time to diagnosis was significantly longer in the PoTS UK cohort (p=0.04). Symptom severity was comparable between cohorts. The PoTS total group was compared with a matched CFS cohort; despite comparable levels of fatigue and sleepiness, autonomic symptom burden (OGS) was statistically significantly higher. The most common treatment regime included β-blockers. Overall, 21 treatment combinations were described. Up to 1/3 were taking no treatment.
  
  
  CONCLUSIONS
  Patients with PoTS are predominantly women, young, well educated and have significant and debilitating symptoms that impact significantly on quality of life. Despite this, there is no consistent treatment.
authors.affiliation: Institute for Ageing & Health, Campus for Ageing & Vitality, Medical School, Newcastle University, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: McDonald
authors.affiliation: Institute for Ageing & Health, Campus for Ageing & Vitality, Medical School, Newcastle University, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
authors.forename: Sharon
authors.initials: S
authors.lastname: Koshi
authors.affiliation: PoTs UK, www.potsuk.org.
authors.forename: Lorna
authors.initials: L
authors.lastname: Busner
authors.affiliation: PoTs UK, www.potsuk.org.
authors.forename: Lesley
authors.initials: L
authors.lastname: Kavi
authors.affiliation: Institute for Ageing & Health, Campus for Ageing & Vitality, Medical School, Newcastle University, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
authors.forename: Julia L
authors.initials: JL
authors.lastname: Newton
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D054972:Postural Orthostatic Tachycardia Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology; D006113:United Kingdom; D055815:Young Adult
keywords: Clinical Physiology; General Medicine (see Internal Medicine)