Compression Garment Reduces Orthostatic Tachycardia and Symptoms in Patients With [POTS], 2021, Bourne et al

Compression Garment Reduces Orthostatic Tachycardia and Symptoms in Patients With Postural Orthostatic Tachycardia Syndrome

Kate M. Bourne et al

"Abstract

Background
Postural orthostatic tachycardia syndrome (POTS) is a chronic form of orthostatic intolerance associated with a significant symptom burden. Compression garments are a frequently prescribed treatment, but the effectiveness of waist-high compression has not been evaluated in adults with POTS.

Objectives
This study evaluated compression garments as a treatment for POTS using a head-up tilt test (HUT), and a noninflatable core and lower body compression garment.

Methods
Thirty participants completed 10-min HUT with each of 4 compression conditions in a randomized crossover design. The conditions were no compression (NONE), lower leg compression (LEG), abdominal/thigh compression (ABDO), and full abdominal/leg compression (FULL). Heart rate, beat-to-beat blood pressure, and Vanderbilt Orthostatic Symptom Score ratings were measured during each HUT.

Results
The compression garment reduced heart rate (NONE: 109 ± 19 beats/min; LEG: 103 ± 16 beats/min; ABDO: 97 ± 15 beats/min; FULL: 92 ± 14 beats/min; p < 0.001) and improved symptoms (p < 0.001) during HUT in a dose-dependent manner. During HUT, stroke volume and systolic blood pressure were better maintained with FULL and ABDO compression compared with LEG and NONE compression.

Conclusions
Abdominal and lower body compression reduced heart rate and improved symptoms during HUT in adult patients with POTS. These effects were driven by improved stroke volume with compression. Abdominal compression alone might also provide a clinical benefit if full lower body compression is not well tolerated. (Hemodynamic Effects of Compression in POTS;"

https://www.jacc.org/doi/10.1016/j.jacc.2020.11.040

 

There's a useful presentation on this study from the authors here:

https://www.youtube.com/watch?v=9iHIXu4Vv_I

For what its worth I've been using abdominal compression for a while now and I find it particularly useful after meals, especially if I'm stationary, sitting at my desk. It feels like I can work for longer with it on and I don't find it massively uncomfortable or restrictive.

From the video:


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i remember reading about the proposal for support tights 20 years ago in an AfME mag.

 

I wear them and they help to stop fluid pooling in my legs. I also sleep with my head raised - have done for years - as this helped POTS.
I'd love a full body compression suit - legs up to chest. I think they do them for astronauts?!

 

I was actually invited to participate in this study and i declined, because the trip alone would have cost me a lot and i didn’t feel it was worth the investment. Compression stockings are not acceptable treatments for me due to being hard to install and uninstall. And then you have to wash them. And then it's way too hot.