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The most common cause of syncope and falls in elders is carotid sinus hypersensitivity (CSH). To determine CSH prevalence in an unselected population of elders, researchers invited 1000 general practice patients (age, 65 or older) to undergo carotid sinus massage (CSM).
Ultimately, 272 patients (median age, 71; 57% men) underwent CSM. The protocol was 5 seconds of massage over the point of maximal carotid pulsation on the left and right sides, both while the patient was supine and while tilted to 70 degrees. Cardioinhibitory CSH was defined as asystole of ≥3 seconds with a systolic blood pressure drop of <50 mm Hg; vasodepressor CSH as an SBP drop of ≥50 mm Hg; and mixed CSH as a combination of the two.
One hundred seven patients (39%) exhibi…