A Community-Based Trial of Commercially Available Compression Tights in Patients With Postural Orthostatic Tachycardia Syndrome.

BACKGROUND

Compression garments reduce heart rate and symptoms in patients with postural orthostatic tachycardia syndrome in an acute laboratory setting. Patients taking medications controlling heart rate have less benefit from compression than those not on medications. The effectiveness of commercially available garments in a community-based setting, with and without medication use, is not known.

OBJECTIVES

The authors sought to evaluate commercially available compression tights in a community-based setting both with, and without, medications modulating heart rate, using a clinical trial with 2 before-after protocols conducted in a randomized crossover fashion.

METHODS

Participants (N = 26) held medications during protocol #1 and took medications as normal during protocol #2. For each, participants completed 4, 10-minute active stand tests in the morning (AM) and afternoon (PM) with the garments on (ON) and off (OFF) (AM-OFF, AM-ON, PM-ON, and PM-OFF). Heart rate (Holter monitor) and symptoms (Vanderbilt Orthostatic Symptom Score [VOSS]) were measured for each standing test.

RESULTS

Protocol #1: Standing heart rate was reduced (105 [99-116] beats/min vs 119 [105-130] beats/min; P < 0.001) and symptoms improved (P < 0.001), during AM-ON vs AM-OFF. Standing heart rate (P = 0.04) and symptoms (P = 0.004) increased when compression was removed after several hours. Protocol #2: Standing heart rate was reduced (84 [77-90] beats/min vs 89 [84-100] beats/min; P < 0.001), and symptoms improved (P = 0.03), during AM-ON vs AM-OFF. Standing heart rate (P = 0.02) and symptoms (P < 0.001) increased when compression was removed after several hours.

CONCLUSIONS

Commercially available compression tights reduced heart rate and symptoms both acutely and after several hours of use. This additional benefit persisted whether concomitant medications were used. (Compression Garments in the Community With POTS [COM-COM-POTS]; NCT04881318).