title: Racial Differences in Response to Tilt-Table Testing in Patients Refered.
abstract: BACKGROUND
  Syncope is a common problem in the general population and results in significant societal and patient costs. Several small studies have demonstrated differences in orthostatic response, and possibly tolerance, between blacks and whites. Based on these observations, we retrospectively reviewed results from our tilt table database to identify potential differences in response to tilt-table testing with regards to race, between black and white patients.
  
  
  METHODS
  The reports of 446 tilt-table tests performed on adults, older than 18 years of age, at Boston Medical Center, an urban, tertiary-care, academic hospital, were reviewed. Clinical variables were retrieved from the procedure report. Occurrence of syncope was noted and hemodynamic classification was recorded as neurocardiogenic response, with subcategories of mixed, vasodepressor, or cardio-inhibitory.
  
  
  RESULTS
  Of records reviewed, 360 patients (80.7%) identified as white and 86 patients as black (19.3%). There was a significantly lower observed frequency of syncope with a neurocardiogenic response in black vs. white patients (45.5% vs. 60.3%, p=0.015). In addition, significantly fewer black patients demonstrated a mixed neuro-cardiogenic response as compared to white patients (7.0% vs. 15.8%, p=0.038) or cardio-inhibitory response (0% vs. 5.3%, p=0.032). There was no difference in frequency of vasodepressor response in black vs. white patients (39.2 vs.38.4%, p=1.000).
  
  
  CONCLUSIONS
  We observed a statistically-significant lower incidence of neurocardiogenic syncope among black patients compared to white patients referred for tilt-table testing for evaluation of syncope.
authors.affiliation: Louisiana State University Health Sciences Center - New Orleans, LA.
authors.forename: Jameel
authors.initials: J
authors.lastname: Ahmed
authors.affiliation: Department of medicine, University of Texas Medical Branch in Galveston, TX.
authors.forename: Peerawut
authors.initials: P
authors.lastname: Deeprasertkul
authors.affiliation: Department of medicine, Boston University School of Medicine in Boston, MA.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Monahan
authors.affiliation: Louisiana State University Health Sciences Center - New Orleans, LA.
authors.forename: Paul
authors.initials: P
authors.lastname: LeLorier
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People / Q000706:statistics & numerical data*; D005260:Female; D018475:Head-Down Tilt / Q000009:adverse effects*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D019462:Syncope, Vasovagal / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology; D018667:Tilt-Table Test; D014481:United States / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult; D001741:Black or African American