Original Article
Quality of Life in Patients With Postural Tachycardia Syndrome

https://doi.org/10.4065/77.6.531Get rights and content

Objectives: To quantify quality of life and identify demographic and clinical correlates of functioning in a well-characterized sample of patients with postural tachycardia syndrome (POTS).

Patients and Methods

Prospective patients were those seen at the Mayo Clinic Autonomic Disorders Laboratory from September 2000 to June 2001. Neurologists made diagnoses of POTS according to established criteria. Patients completed a questionnaire packet that included measures of quality of life (36-Item Short-Form Health Survey [SF-36]) and symptom severity (Autonomic Symptom Profile). Additional clinical information was abstracted from medical records.

Results

Ninety-four patients (89% female; mean age, 34.2 years) were enrolled in the study. Patients with POTS reported impairment across multiple domains on the SF-36. Physical functioning, role functioning, bodily pain, general health, vitality, and social functioning were all significantly impaired compared with a healthy population (P<.01 for all) and similar to that reported by patients with other chronic, disabling conditions. Hierarchical regression analyses revealed that symptom severity (β = -.36, P<.001) and disability status (β = -.36, P<.001) were independent predictors of SF-36 physical component scores, with the full model accounting for 54% of the variance (P<.001). None of the variables examined accounted for a significant amount of the variance in SF-36 mental component scores.

Conclusions

Patients with POTS experience clear limitations across multiple domains of quality of life, including physical, social, and role functioning. Treatment should address the multiple and varied impairments experienced by these patients and may require a multidisciplinary approach. Future research must further delineate factors, both disease related and psychosocial, that predict functioning and adjustment in this population.

Section snippets

PATIENTS AND METHODS

Study participants were recruited through the Mayo Clinic Autonomic Disorders Laboratory. All patients had a complete general medical and neurologic evaluation and a full autonomic reflex laboratory evaluation before participating in the study. Inclusion criteria were as follows: (1) men or women age 18 years or older; (2) sustained heart rate increment of 30 beats/min or greater within 5 minutes of head-up tilt; and (3) symptoms of orthostatic intolerance, including weakness, light-headedness,

Sample Characteristics

Of the 113 questionnaires returned, 19 (17%) were excluded from analyses because the participants did not meet full inclusion criteria. An additional 25 participants had a heart rate increment of 30 beats/min or more but did not sustain a heart rate of at least 120 beats/min throughout the tilt. These participants were compared to the rest of the sample on all the variables of interest. Results of Mann-Whitney U tests revealed no significant differences on any of the study measures except for 1

DISCUSSION

To our knowledge, this study is the first to quantify the degree of functional impairment in patients with POTS. Patients reported clear limitations in several domains of functioning, particularly energy level and role functioning. In our sample, reported functioning was comparable to that of patients with COPD or CHF, 2 chronic, symptomatic conditions generally present in a much older patient population. The average patient with POTS is a young, highly educated, previously healthy woman2 (mean

CONCLUSIONS

This study is the first to our knowledge that systematically investigates quality of life in a well-characterized sample of patients with POTS. Results show that these patients experience significant limitations across several domains of quality of life, including physical, social, and role functioning. Health care practitioners must recognize the multiple impairments that often accompany POTS and address not only the physical aspects of the condition but also the social ones. More research is

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This study was supported in part by grants PPG NS3 2352 and HD07447 from the National Institutes of Health.

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