Association between complaints of dizziness and hypertension in non-institutionalized elders

Lopes, Anália Rosário; Moreira, Michelle Damasceno; Trelha, Celita Salmaso; Marchiori, Luciana Lozza de Moraes

doi:10.7162/s1809-97772013000200007

Cited by 10 publications

(5 citation statements)

References 19 publications

(17 reference statements)

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“…A cross-sectional study of 493 patients by Lopes AR et al demonstrates dizziness to be significantly associated with hypertension (p = 0.01). 9 Our research supports this study showing a statistically significant association between systemic arterial hypertension and abnormal MRI findings in patients presenting with vertigo. Hypertension is a significant risk factor for cerebrovascular accidents which may lead to the areas of ischemia in the cerebellum and brain stem manifesting as dizziness and vertigo.…”

Section: Resultssupporting

confidence: 90%

MRI Findings of Patients Presenting with Vertigo to the Otorhinolaryngology OPD of a Tertiary Care Center of Western Nepal

Rai

Koirala

Yogi

et al. 2020

Eastern Green Neurosurg.

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Background: Dizziness is a common symptom affecting about 30% of people over the age of 65years. In this study, we tried to determine the usefulness of MRI in evaluating the causes of vertigo presenting in ENT outpatient clinics. Materials and methods: We retrospectively analyzed 98 vertigo patients, who came or were referred to outpatient clinics of Otorhinolaryngology Department of Manipal College of Medical Sciences, Pokhara, Nepal. MR imaging of the head and cervical spine was performed in all patients with exception of those with vertigo secondary to trauma, drugs, cardiovascular, or patients in whom MRI was contraindicated. Demographics, comorbidities, and MRI findings were evaluated. Results: There were 98 patients fulfilling the study criteria in our study. There were 41 males (41.84%) and 57 females (58.26%) with M: F ratio of 0.70. The mean age of the patients included in the study was 52.16±14.524 years (21-84 years). Systemic arterial hypertension was the only parameter showing statistically significant against normal and abnormal MRI findings (p-value =0.017) in patients presenting with vertigo. Cervical findings (Prolapsed Disc and Canal stenosis) were the commonest positive findings in MRI (n=27, 27.6%) followed by White matter lesions in the brain (18, 18.4%) and cerebral infarcts (n=12, 12.2%). Conclusion: The utility of MRI may not be high in patients with acutely isolated vertigo however MRI has indicated if it suggests central cause with neurological signs and symptoms, risk factors of the cerebral vascular accident, treatment-resistant cases or cases with diagnostic uncertainty. Abnormalities in MRI are common in patients with co-existing dizziness and systemic arterial hypertension.

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Section: Resultssupporting

confidence: 90%

MRI Findings of Patients Presenting with Vertigo to the Otorhinolaryngology OPD of a Tertiary Care Center of Western Nepal

Rai

Koirala

Yogi

et al. 2020

Eastern Green Neurosurg.

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“…Several potential mechanisms linking dizziness with cardiovascular disease and diabetes have been suggested. Patients experiencing symptomatic dizziness often limit physical activity due to a fear of falling, which may contribute to the development of cardiovascular disease and diabetes . Conversely, hypertension has been proposed to cause dizziness because it may reduce blood supply to the vestibular labyrinth, leading to vestibular symptoms .…”

Section: Discussionmentioning

confidence: 99%

“…Patients experiencing symptomatic dizziness often limit physical activity due to a fear of falling, which may contribute to the development of cardiovascular disease and diabetes. [36][37][38] Conversely, hypertension has been proposed to cause dizziness because it may reduce blood supply to the vestibular labyrinth, leading to vestibular symptoms. [39][40][41] Severe cases of uncontrolled hypertension may affect both cerebral and labyrinthine vasculature, causing cen-tral and peripheral vestibular symptoms.…”

Section: Discussionmentioning

confidence: 99%

Association of Symptomatic Dizziness With All-Cause and Cause-Specific Mortality

Lin,

Gallagher,

Straughan

et al. 2024

JAMA Otolaryngol Head Neck Surg

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ImportanceDizziness is a highly prevalent complaint with wide-ranging causes and resultant morbidity. Whether symptomatic dizziness and its various manifestations are associated with all-cause and cause-specific mortality is unknown.ObjectiveTo examine the associations of symptomatic dizziness and its manifestations with all-cause and cause-specific mortality.Design, Setting, and ParticipantsThis cohort study is a mortality follow-up study based on the 1999-2004 National Health and Nutrition Examination Survey. The study cohort included adults 40 years and older who completed questions about symptomatic dizziness, including problems with dizziness, balance, falling, and positional dizziness, within the past 12 months. Respondents were linked to mortality data through December 31, 2019. Data were analyzed from February to August 2023.ExposureSelf-reported symptomatic dizziness.Main Outcomes and MeasuresAll-cause and cause-specific (cardiovascular disease, diabetes, cancer, and unintentional injuries) mortality. Cox proportional hazard regression models were used to examine associations between symptomatic dizziness and all-cause and cause-specific mortality while adjusting for demographics and medical history.ResultsIn this nationally representative cohort of 9000 middle-aged and older US adults (mean [SD] age, 61.8 [13.8] years; 4570 [50.8%] female), prevalence of symptomatic dizziness was 23.8%. Specifically, 18.3% reported problems with dizziness, 14.5% reported problems with balance, 5.7% reported problems with falling, and 3.8% reported dizziness when turning in bed (positional dizziness). At a median (range) of 16.2 (0.1-20.6) years of follow-up, all-cause mortality for adults with symptomatic dizziness was higher than for those without (45.6% vs 27.1%). Symptomatic dizziness was associated with elevated risk for cause-specific mortality from diabetes (hazard ratio [HR], 1.66; 95% CI, 1.23-2.25), cardiovascular disease (HR, 1.33; 95% CI, 1.12-1.55), and cancer (HR, 1.21; 95% CI, 0.99-1.47) but not unintentional injuries (HR, 0.98; 95% CI, 0.51-1.88). Reporting problems with balance or falling was associated with increased all-cause mortality (balance: HR, 1.27; 95% CI, 1.17-1.39; and falling: HR, 1.52; 95% CI, 1.33-1.73), cardiovascular disease–specific mortality (balance: HR, 1.41; 95% CI, 1.20-1.66; and falling: HR, 1.49; 95% CI, 1.15-1.94), and diabetes-specific mortality risks (balance: HR, 1.74; 95% CI, 1.26-2.39; and falling: HR, 2.01; 95% CI, 1.26-3.18). There was no association between positional dizziness and mortality (HR, 0.98; 95% CI, 0.82-1.19).Conclusions and RelevanceIn this cohort study, symptomatic dizziness was associated with increased risk for all-cause and diabetes-, cardiovascular disease–, and cancer-specific mortality. The imprecision of the effect size estimate for cancer-specific mortality prevents making a definitive conclusion. Future studies are needed to determine whether symptomatic dizziness indicates underlying health conditions contributing to mortality or if early intervention for imbalance and falls can reduce mortality risk.

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“…Five patients were diagnosed with uncontrolled hypertension, making up 28% of the symptomatic group. In general, hypertension and dizziness are both highly prevalent and significantly associated, highlighting a pressing need for investments in preventive measures [ 23 ]. BPPV is the most common of the peripheral types of vertigo.…”

Section: Discussionmentioning

confidence: 99%

Vertigo in Patients with Degenerative Cervical Myelopathy

Kadaňka

Jura

Bednařík

2021

JCM

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(1) Background: Cervical vertigo (CV) represents a controversial entity, with a prevalence ranging from reported high frequency to negation of CV existence. (2) Objectives: To assess the prevalence and cause of vertigo in patients with a manifest form of severe cervical spondylosis–degenerative cervical myelopathy (DCM) with special focus on CV. (3) Methods: The study included 38 DCM patients. The presence and character of vertigo were explored with a dedicated questionnaire. The cervical torsion test was used to verify the role of neck proprioceptors, and ultrasound examinations of vertebral arteries to assess the role of arteriosclerotic stenotic changes as hypothetical mechanisms of CV. All patients with vertigo underwent a detailed diagnostic work-up to investigate the cause of vertigo. (4) Results: Symptoms of vertigo were described by 18 patients (47%). Causes of vertigo included: orthostatic dizziness in eight (22%), hypertension in five (14%), benign paroxysmal positional vertigo in four (11%) and psychogenic dizziness in one patient (3%). No patient responded positively to the cervical torsion test or showed significant stenosis of vertebral arteries. (5) Conclusions: Despite the high prevalence of vertigo in patients with DCM, the aetiology in all cases could be attributed to causes outside cervical spine and related nerve structures, thus confirming the assumption that CV is over-diagnosed.

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Association between complaints of dizziness and hypertension in non-institutionalized elders

Cited by 10 publications

References 19 publications

MRI Findings of Patients Presenting with Vertigo to the Otorhinolaryngology OPD of a Tertiary Care Center of Western Nepal

MRI Findings of Patients Presenting with Vertigo to the Otorhinolaryngology OPD of a Tertiary Care Center of Western Nepal

Association of Symptomatic Dizziness With All-Cause and Cause-Specific Mortality

Vertigo in Patients with Degenerative Cervical Myelopathy

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