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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Developed in collaboration with, European Heart Rhythm Association (EHRA), Heart Failure Association (HFA), and Heart Rhythm Society (HRS), Endorsed by the following societies, European Society of Emergency Medicine (EuSEM), European Federation of Internal Medicine (EFIM), European Union Geriatric Medicine Society (EUGMS), American Geriatrics Society (AGS), European Neurological Society (ENS), et al.
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