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      The face of postural tachycardia syndrome – insights from a large cross‐sectional online community‐based survey

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          Abstract

          Background

          Patients with postural tachycardia syndrome ( POTS) experience chronic symptoms of orthostatic intolerance. There are minimal data detailing the demographics, clinical features and clinical course of this condition. This online, community‐based survey highlights patients’ experience with POTS. It consists of the largest sample of POTS patients reported to date.

          Objectives

          To describe the demographics, past medical history, medications, treatments and diagnostic journey for patients living with POTS.

          Methods

          Postural tachycardia syndrome patients completed an online, community‐based, cross‐sectional survey. Participants were excluded if they had not received a diagnosis of POTS from a physician. The questions focused on the patient experience and journey, rather than physiological responses.

          Results

          The final analysis included 4835 participants. POTS predominantly affects white (93%) females (94%) of childbearing age, with approximately half developing symptoms in adolescence (mode 14 years). POTS is a chronic multisystem disorder involving a broad array of symptoms, with many patients diagnosed with comorbidities in addition to POTS. POTS patients often experience lengthy delays [median (interquartile range) 24 (6–72) months] and misdiagnosis, but the diagnostic delay is improving. POTS patients can present with a myriad of symptoms most commonly including lightheadedness (99%), tachycardia (97%), presyncope (94%), headache (94%) and difficulty concentrating (94%).

          Conclusions

          These data provide important insights into the background, clinical features and diagnostic journey of patients suffering from POTS. These data should serve as an essential step for moving forward with future studies aimed at early and accurate diagnoses of these patients leading to appropriate treatments for their symptoms.

          Abstract

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          Most cited references35

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          Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis.

          Many cross-sectional surveys have reported the prevalence of irritable bowel syndrome (IBS), but there have been no recent systematic review of data from all studies to determine its global prevalence and risk factors. MEDLINE, EMBASE, and EMBASE Classic were searched (until October 2011) to identify population-based studies that reported the prevalence of IBS in adults (≥15 years old); IBS was defined by using specific symptom-based criteria or questionnaires. The prevalence of IBS was extracted for all studies and based on the criteria used to define it. Pooled prevalence, according to study location and certain other characteristics, odds ratios (ORs), and 95% confidence intervals (CIs) were calculated. Of the 390 citations evaluated, 81 reported the prevalence of IBS in 80 separate study populations containing 260,960 subjects. Pooled prevalence in all studies was 11.2% (95% CI, 9.8%-12.8%). The prevalence varied according to country (from 1.1% to 45.0%) and criteria used to define IBS. The greatest prevalence values were calculated when ≥3 Manning criteria were used (14%; 95% CI, 10.0%-17.0%); by using the Rome I and Rome II criteria, prevalence values were 8.8% (95% CI, 6.8%-11.2%) and 9.4% (95% CI, 7.8%-11.1%), respectively. The prevalence was higher for women than men (OR, 1.67; 95% CI, 1.53-1.82) and lower for individuals older than 50 years, compared with those younger than 50 (OR, 0.75; 95% CI, 0.62-0.92). There was no effect of socioeconomic status, but only 4 studies reported these data. The prevalence of IBS varies among countries, as well as criteria used to define its presence. Women are at slightly higher risk for IBS than men. The effects of socioeconomic status have not been well described. Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.
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            Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome.

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                Author and article information

                Contributors
                satish.raj@ucalgary.ca
                Journal
                J Intern Med
                J. Intern. Med
                10.1111/(ISSN)1365-2796
                JOIM
                Journal of Internal Medicine
                John Wiley and Sons Inc. (Hoboken )
                0954-6820
                1365-2796
                16 April 2019
                October 2019
                : 286
                : 4 ( doiID: 10.1111/joim.v286.4 )
                : 438-448
                Affiliations
                [ 1 ] Department of Cardiac Sciences Libin Cardiovascular Institute of Alberta University of Calgary Calgary AB Canada
                [ 2 ] Department of Neurology Stony Brook University School of Medicine Stony Brook NY USA
                [ 3 ] Dysautonomia International East Moriches NY USA
                [ 4 ] Autonomic Dysfunction Center Division of Clinical Pharmacology Vanderbilt University Medical Center Nashville TN USA
                [ 5 ] Department of Psychiatry University of Calgary Calgary AB Canada
                Author notes
                [*] [* ] Correspondence: Satish R. Raj, MD, MSCI, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, GAC70 HRIC Bldg, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6, Canada.

                (fax: (403) 210‐9444; e‐mail: satish.raj@ 123456ucalgary.ca ).

                Author information
                https://orcid.org/0000-0003-2733-8274
                Article
                JOIM12895
                10.1111/joim.12895
                6790699
                30861229
                93e15d5a-328e-486f-9a56-7dce175c96b2
                © 2019 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                Page count
                Figures: 3, Tables: 4, Pages: 11, Words: 6445
                Funding
                Funded by: Cardiac Arrhythmia Network of Canada
                Award ID: SRG‐15‐P01‐001 and SRG‐17‐P27‐001
                Funded by: National Heart, Lung, And Blood Institute of the National Institutes of Health , open-funder-registry 10.13039/100000050;
                Award ID: P01 HL056693
                Funded by: National Center for Advancing Translational Sciences Award
                Award ID: UL1 TR000445
                Funded by: Canadian Institutes of Health Research , open-funder-registry 10.13039/501100000024;
                Award ID: MOP142426
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                October 2019
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.0 mode:remove_FC converted:14.10.2019

                Internal medicine
                autonomic nervous system,orthostatic intolerance
                Internal medicine
                autonomic nervous system, orthostatic intolerance

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