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Europace Advance Access published online on August 18, 2006
Europace, doi:10.1093/europace/eul092
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© The European Society of Cardiology 2006. All rights reserved
Received February 22, 2006
Accepted May 11, 2006

Article

Familial aggregation of fainting in a case-control study of neurally mediated hypotension patients who present with unexplained chronic fatigue

Katherine E. Lucas 1 *, Haroutune K. Armenian 2, Gloria M. Petersen 3, and Peter C. Rowe 4

1 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, E6148, Baltimore, MD 21205, USA; Department of Pediatrics, Johns Hopkins School of Medicine, Brady 212, 600 N. Wolfe Street, Baltimore, MD 21287, USA
2 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, E6148, Baltimore, MD 21205, USA
3 Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, 200 First Street, SW, Rochester, MN 55905, USA
4 Department of Pediatrics, Johns Hopkins School of Medicine, Brady 212, 600 N. Wolfe Street, Baltimore, MD 21287, USA

* To whom correspondence should be addressed.
Katherine E. Lucas, E-mail: kalucas{at}jhmi.edu


  Abstract

Aims We hypothesized that family history of fainting is a risk factor for adult-onset neurally mediated hypotension (NMH) in patients who present with chronic fatigue rather than fainting.

Methods and results A nested case-control study of Gulf War veterans gathered fainting histories directly from 197 first-degree relatives of 16 fatigued NMH cases, 26 fatigued controls, and 17 healthy controls. NMH status was determined by tilt testing. Female relatives of fatigued controls reported more fainting than female relatives of cases (P < 0.01); there were no significant differences in the frequency of fainting in male relatives by case or control status, or in either gender by age at first faint or by familial relationship to the proband. The odds of NMH patients giving any family history of fainting were 0.56 (95% CI 0.15, 2.07). Recurrence risks calculated using lifetime prevalences of fainting in male military personnel of similar age to our participants were low (1.5-1.7) and did not differ by case or control status.

Conclusion Family history of fainting is not a risk factor for adult-onset NMH in fatigued veterans. Our findings may differ from other studies of familial aggregation in NMH because of study methods or because NMH-fatiguers may differ from NMH-fainters.

Keywords: Fatigue; Heredity; Gulf War syndrome; Vasovagal syncope.
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