Lower Limb and Abdominal Compression Bandages Prevent Progressive Orthostatic Hypotension in Elderly Persons: A Randomized Single-Blind Controlled Study Original Research Article

Objectives This study sought to assess the efficacy of compression bandage of legs and abdomen in preventing hypotension and symptoms. Background Progressive orthostatic hypotension can occur in elderly people during standing. Methods Twenty-one patients (70 ± 11 years) affected by symptomatic progressive orthostatic hypotension underwent 2 tilt-test procedures, with and without elastic bandage of the legs (compression pressure 40 to 60 mm Hg) and of the abdomen (compression pressure 20 to 30 mm Hg) in a randomized crossover fashion. Leg bandage was administered for 10 min and was followed by an additional abdominal bandage for a further 10 min. Symptoms were evaluated by a 7-item Specific Symptom Score (SSS) questionnaire before and after 1 month of therapy with elastic compression stockings of the legs (prescribed in all patients irrespective of the results of the tilt study). Results In the control arm, systolic blood pressure decreased from 125 ± 18 mm Hg immediately after tilting to 112 ± 25 mm Hg after 10 min of sham leg bandage and to 106 ± 25 mm Hg after 20 min despite the addition of sham abdominal bandage. The corresponding values with active therapy were 129 ± 19 mm Hg, 127 ± 17 mm Hg (p = 0.003 vs. control), and 127 ± 21 mm Hg (p = 0.002 vs. control). In the active arm, 90% of patients remained asymptomatic, versus 53% in the control arm (p = 0.02). During the month before evaluation, the mean SSS score was 35.2 ± 12.1 with dizziness, weakness, and palpitations accounting for 64% of the total score. The SSS score decreased to 22.5 ± 11.3 after 1 month of therapy (p = 0.01). Conclusions Lower limb compression bandage is effective in avoiding orthostatic systolic blood pressure decrease and in reducing symptoms in elderly patients affected by progressive orthostatic hypotension.