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Cardiac effects of carotid sinus massage in old age
Insights
Carotid sinus massage effects were studied in older adults. While generally safe, men showed an age-related increase in response, potentially explaining higher syncope rates in males.
Area of Science:
- Cardiology
- Gerontology
- Neurology
Background:
- Carotid sinus massage (CSM) is used to assess baroreceptor function.
- Aged individuals often have arteriosclerosis, potentially affecting CSM response.
- Carotid sinus syndrome (CSS) with syncope is more common in men.
Purpose of the Study:
- To investigate the effects of CSM in elderly subjects.
- To compare CSM responses between sexes and with age.
- To evaluate the safety and implications of CSM in the aged population.
Main Methods:
- CSM was performed on 71 men and 315 women aged 65 and older.
- Heart rate response to CSM was measured.
- Side effects and side of response were recorded.
Main Results:
- A heart rate slowing >10% occurred in 25% of men and 19% of women (not statistically significant by sex).
- Men showed a significant increase in response with age; women had a right-sided response preponderance.
- CSM was safe, but caution advised to avoid carotid compression.
Conclusions:
- Carotid sinus sensitivity may diminish with age.
- Men's age-related increase in CSM response may contribute to higher CSS syncope incidence.
- CSM is a safe diagnostic tool in the elderly when performed correctly.
Abstract:
The effects of carotid sinus massage in aged subjects with a high incidence of arteriosclerosis are described. In 71 men and 315 women tested, a slowing of more than 10 per cent of the heart rate was found in 25 per cent of the men and 19 per cent of the women, which is not of statistical significance in relation to sex. Only men showed a significant increase with age and the women had a significant preponderance of a right-sided response. The technique was found to be safe, although a review of reported side-effects suggests care is advisable and carotid compression must not occur. The findings are discussed in relation to those reported in younger subjects and in carotid sinus syndrome with syncope. The fact that men have an acquired increase in response in old age, which is not seen in women, may be a factor of importance in the explanation of why carotid sinus syncope is almost always seen in men. Carotid sinus sensitivity appears to diminish in old age and some of the ageing factors which might influence the carotid sinus reflex are examined.