CLINICAL RESEARCH: ORTHOSTATIC HYPOTENSION
Lower Limb and Abdominal Compression Bandages Prevent Progressive Orthostatic Hypotension in Elderly Persons
A Randomized Single-Blind Controlled Study
Cristian Podoleanu, MD*,
Roberto Maggi, MD ,
Michele Brignole, MD,*,
Francesco Croci, MD,
Alexander Incze, MD*,
Alberto Solano, MD,
Enrico Puggioni, MD and
Emilian Carasca, MD*
* Cardiologie–Clinica Medicala 4, Spitalul Clinic de Urgenta, University Hospital, Targu Mures, Romania
Department of Cardiology and Arrhythmologic Center, Ospedali del Tigullio, Lavagna, Italy
Manuscript received March 27, 2006;
revised manuscript received May 8, 2006,
accepted May 29, 2006.
* Reprint requests and correspondence: Dr. Michele Brignole, Department of Cardiology, Arrhythmologic Center, Ospedali del Tigullio, Via don Bobbio 24, 16033 Lavagna, Italy (Email: mbrignole{at}ASL4.liguria.it).
OBJECTIVES: This study sought to assess the efficacy of compression bandage of legs and abdomen in preventing hypotension and symptoms.
BACKGROUND: Progressive orthostatic hypotension can occur in elderly people during standing.
METHODS: Twenty-one patients (70 ± 11 years) affected by symptomatic progressive orthostatic hypotension underwent 2 tilt-test procedures, with and without elastic bandage of the legs (compression pressure 40 to 60 mm Hg) and of the abdomen (compression pressure 20 to 30 mm Hg) in a randomized crossover fashion. Leg bandage was administered for 10 min and was followed by an additional abdominal bandage for a further 10 min. Symptoms were evaluated by a 7-item Specific Symptom Score (SSS) questionnaire before and after 1 month of therapy with elastic compression stockings of the legs (prescribed in all patients irrespective of the results of the tilt study).
RESULTS: In the control arm, systolic blood pressure decreased from 125 ± 18 mm Hg immediately after tilting to 112 ± 25 mm Hg after 10 min of sham leg bandage and to 106 ± 25 mm Hg after 20 min despite the addition of sham abdominal bandage. The corresponding values with active therapy were 129 ± 19 mm Hg, 127 ± 17 mm Hg (p = 0.003 vs. control), and 127 ± 21 mm Hg (p = 0.002 vs. control). In the active arm, 90% of patients remained asymptomatic, versus 53% in the control arm (p = 0.02). During the month before evaluation, the mean SSS score was 35.2 ± 12.1 with dizziness, weakness, and palpitations accounting for 64% of the total score. The SSS score decreased to 22.5 ± 11.3 after 1 month of therapy (p = 0.01).
CONCLUSIONS: Lower limb compression bandage is effective in avoiding orthostatic systolic blood pressure decrease and in reducing symptoms in elderly patients affected by progressive orthostatic hypotension.
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Abbreviations and Acronyms
| | SSS-OI = Specific Symptom Scale Questionnaire for Orthostatic Intolerance |
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