Low blood pressure phenotype underpins the tendency to reflex syncope
Bibliographic record
Abstract
Abstract BACKGROUND We hypothesized that cardiovascular physiology differs in reflex syncope patients compared with general population, predisposing such subjects to vasovagal reflex. METHODS In this multicohort cross-sectional study, we compared resting systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP) and heart rate (HR), collected from 6 community-based cohort studies (64,968 observations) with those from 6 databases of reflex syncope patients (6516 observations), subdivided by age decades and sex. RESULTS Overall, in males with reflex syncope, SBP (−3.4 mmHg) and PP (−9.2 mmHg) were lower and DBP (+2.8 mmHg) and HR (+5.1 bpm) were higher than in the general population; the difference in SBP was higher at ages >60 years. In females, PP (−6.0 mmHg) was lower and DBP (+4.7 mmHg) and HR (+4.5 bpm) were higher than in the general population; differences in SBP were less pronounced, becoming evident only above 60 years. Compared with males, SBP in females exhibited slower increase until age 40, and then demonstrated steeper increase that continued throughout life. CONCLUSION The patients prone to reflex syncope demonstrate a different resting cardiovascular hemodynamic profile characterized by reduced venous return and stroke volume, evidenced by lower SBP and PP, and compensatory increase in HR and vascular resistance, the latter expressed by elevated DBP. The data presented here contribute to our understanding why some subjects with similar demographic characteristics develop reflex syncope and others not.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".