With all the proven benefits of standing, it seems that a small group of women may be better off sitting or lying down. That’s because 170 out of 100,000 Americans have a condition known as postural tachycardia syndrome, a somewhat mysterious condition in which heart rates rise considerably after standing up. Hoping to further enlighten themselves and clinicians around the world, researchers from Newcastle University in the UK sought to identify symptoms of the condition and the people who are most affected.   

Also known as postural orthostatic tachycardia syndrome (POTS), it’s byproduct of orthostatic intolerance, which is characterized by the body’s inadequate response to changing posture — from sitting or lying down to standing. Although heart rate usually increases a little when standing up, people with POTS experience excessive increases, which can cause various symptoms, from fainting to dizziness, and poor concentration to trembling. Because many of these symptoms also align with those of anxiety, panic disorder, and chronic fatigue, many doctors misdiagnose it. In turn, the condition becomes even more debilitating, causing symptoms akin to congestive heart failure and chronic obstructive pulmonary disease (COPD).

So, the researchers assessed 136 patients with POTS, measuring their levels of fatigue, sleepiness, anxiety and depression, problems concentrating, and how severe their bodies’ reactions were to standing up. It was a small study, but they found some consistencies throughout the study groups. Interestingly, the majority of people who developed the condition were women, and well-educated at that. Women who attended a specialist were also diagnosed quicker, however, so it could be possible that they were just knowledgeable enough to know that their condition necessitated a specialist’s care. Finally, people who developed the condition were most likely to be diagnosed pretty early in their lives, at an average of 30 to 33, according to a press release.

The findings are important because they highlight the need for accommodating people with the condition. Many people with POTS are forced to change their jobs or give up work altogether because the symptoms were that debilitating. “The symptom burden for those with POTS is high and we have shown it to be comparable to that seen in chronic fatigue syndrome (CFS). CFS is a chronic condition that is recognized by the WHO as a neurological disorder and by the Disability Discrimination Act 2005 as a disability,” the researchers wrote. But while patients with POTS suffer “to the same extent” as those with CFS, they “do not receive the same protection from the law.”

A main treatment for the condition involves beta-blockers, drugs that regulate heart rate. But the participants reported taking as many as 21 different combinations of drugs, while some took none at all. Focusing on those who are more likely to get POTS, and then working to understand the underlying causes, will eventually help the scientists to develop more effective treatments for a condition that they say may worsen over time or never go away.

 

Source: McDonald C, Koshi S, Busner L, Kavi L, Newton J. Postural tachycardia syndrome is associated with significant symptoms and functional impairment predominantly affecting young women: a UK perspective. BMJ Open. 2014.