Compression Garment Reduces Orthostatic Tachycardia and Symptoms in Patients With Postural Orthostatic Tachycardia Syndrome
Open accessAbstract
Background Postural orthostatic tachycardia syndrome (POTS) is a chronic form of orthostatic intolerance associated with a significant symptom burden. Compression garments are a frequently prescribed treatment, but the effectiveness of waist-high compression has not been evaluated in adults with POTS. Objectives This study evaluated compression garments as a treatment for POTS using a head-up tilt test (HUT), and a noninflatable core and lower body compression garment. Methods Thirty participants completed 10-min HUT with each of 4 compression conditions in a randomized crossover design. The conditions were no compression (NONE), lower leg compression (LEG), abdominal/thigh compression (ABDO), and full abdominal/leg compression (FULL). Heart rate, beat-to-beat blood pressure, and Vanderbilt Orthostatic Symptom Score ratings were measured during each HUT. Results The compression garment reduced heart rate (NONE: 109 ± 19 beats/min; LEG: 103 ± 16 beats/min; ABDO: 97 ± 15 beats/min; FULL: 92 ± 14 beats/min; p < 0.001) and improved symptoms (p < 0.001) during HUT in a dose-dependent manner. During HUT, stroke volume and systolic blood pressure were better maintained with FULL and ABDO compression compared with LEG and NONE compression. Conclusions Abdominal and lower body compression reduced heart rate and improved symptoms during HUT in adult patients with POTS. These effects were driven by improved stroke volume with compression. Abdominal compression alone might also provide a clinical benefit if full lower body compression is not well tolerated. (Hemodynamic Effects of Compression in POTS; NCT03484273).
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Compression of the abdomen and legs is more effective than compression of legs alone in patients with POTS.
“Compression of the abdomen and the legs appeared to be more effective than compression of legs alone.42”
From Diagnosis and management of postural orthostatic tachycardia syndrome (2022) · cites this paper as [42]
Lower-body compression garments can mitigate gravity-induced fluid shifts on standing and decrease orthostatic tachycardia and standing tachycardia in patients with POTS.
“Compression garments for the lower body can mitigate the gravity-induced fluid shifts that occur on standing, and decrease orthostatic tachycardia and standing tachycardia as shown in a 2021 randomized crossover study of lower body compression during tilt table testing in patients with POTS.42”
From Diagnosis and management of postural orthostatic tachycardia syndrome (2022) · cites this paper as [42]
All three randomized experimental crossover trials of compression were associated with a significant treatment effect on symptom burden relative to comparison conditions.
“All three trials were associated with a significant treatment effect on symptom burden relative to the comparison conditions.”
From Self-reported symptom burden in postural orthostatic tachycardia syndrome (POTS): A narrative review of observational and interventional studies (2023) · cites this paper as Bourne et al., 2021
The trials of a neck compression collar (5 min) and abdominal and lower body compression (10 min) both improved symptom burden during head-up-tilt.
“both improved symptom burden during head-up-tilt.”
From Self-reported symptom burden in postural orthostatic tachycardia syndrome (POTS): A narrative review of observational and interventional studies (2023) · cites this paper as Bourne et al., 2021
Cites
Sheldon, R. S., Grubb, B. P., Olshansky, B., Shen, W.-K., Calkins, H., Brignole, M., Raj, S. R., Krahn, A. D., Morillo, C. A., Stewart, J. M., et al. (2015) · Heart Rhythm · doi:10.1016/j.hrthm.2015.03.029 · Cited by 1,013 · see citing works
Self-citationCardiac origins of the postural orthostatic tachycardia syndrome
Fu, Q., VanGundy, T. B., Galbreath, M. M., Shibata, S., Jain, M., Hastings, J. L., Bhella, P. S., & Levine, B. D. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.02.043 · Cited by 329 · see citing works
Postural Tachycardia Syndrome (POTS)
Raj, S. R. (2013) · Circulation · doi:10.1161/circulationaha.112.144501 · Cited by 320 · see citing works
Self-citationPostural Orthostatic Tachycardia Syndrome
Bryarly, M., Phillips, L. T., Fu, Q., Vernino, S., & Levine, B. D. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.11.059 · Cited by 245 · see citing works
Raj, S. R., Guzman, J. C., Harvey, P., Richer, L., Schondorf, R., Seifer, C., Thibodeau-Jarry, N., & Sheldon, R. S. (2020) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2019.12.024 · Cited by 223 · see citing works
Self-citationQuality of Life in Patients With Postural Tachycardia Syndrome
Benrud-Larson, L. M., Dewar, M. S., Sandroni, P., Rummans, T. A., Haythornthwaite, J. A., & Low, P. A. (2002) · Mayo Clinic Proceedings · doi:10.4065/77.6.531 · Cited by 217 · see citing works
Acetylcholinesterase inhibition improves tachycardia in postural tachycardia syndrome
Raj, S. R., Black, B. K., Biaggioni, I., Harris, P. A., & Robertson, D. (2005) · Circulation · doi:10.1161/circulationaha.104.497594 · Cited by 171 · see citing works
Self-citationPodoleanu, C., Maggi, R., Brignole, M., Croci, F., Incze, A., Solano, A., Puggioni, E., & Carasca, E. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.06.052 · Cited by 165 · see citing works
Smit, A. J., Wieling, W., Fujimura, J., Denq, J., Opfer-Gehrking, T., Akarriou, M., Karemaker, J., & Low, P. (2004) · Clinical Autonomic Research · doi:10.1007/s10286-004-0187-x · Cited by 153 · see citing works
Regional blood volume and peripheral blood flow in postural tachycardia syndrome
Stewart, J. M., & Montgomery, L. D. (2004) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00086.2004 · Cited by 102 · see citing works
Persistent splanchnic hyperemia during upright tilt in postural tachycardia syndrome
Stewart, J. M., Medow, M. S., Glover, J. L., & Montgomery, L. D. (2006) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00784.2005 · Cited by 95 · see citing works
Okamoto, L. E., Diedrich, A., Baudenbacher, F. J., Harder, R., Whitfield, J. S., Iqbal, F., Gamboa, A., Shibao, C. A., Black, B. K., Raj, S. R., et al. (2016) · Hypertension · doi:10.1161/hypertensionaha.116.07199 · Cited by 79 · see citing works
Self-citationSplanchnic-mesenteric capacitance bed in the postural tachycardia syndrome (POTS)
Tani, H., Singer, W., McPhee, B. R., Opfer-Gehrking, T. L., Haruma, K., Kajiyama, G., & Low, P. A. (2000) · Autonomic Neuroscience · doi:10.1016/s1566-0702(00)00205-8 · Cited by 71 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Vernino, S., Bourne, K. M., Stiles, L. E., Grubb, B. P., Fedorowski, A., Stewart, J. M., Arnold, A. C., Pace, L. A., Axelsson, J., Boris, J. R., et al. (2021) · Autonomic Neuroscience · doi:10.1016/j.autneu.2021.102828 · Cited by 304 · see citing works
Self-citationPost-COVID-19 Tachycardia Syndrome: A Distinct Phenotype of Post-Acute COVID-19 Syndrome
Ståhlberg, M., Reistam, U., Fedorowski, A., Villacorta, H., Horiuchi, Y., Bax, J., Pitt, B., Matskeplishvili, S., Lüscher, T. F., Weichert, I., et al. (2021) · The American Journal of Medicine · doi:10.1016/j.amjmed.2021.07.004 · Cited by 183 · see citing works
Diagnosis and management of postural orthostatic tachycardia syndrome
Raj, S. R., Fedorowski, A., & Sheldon, R. S. (2022) · Canadian Medical Association Journal · doi:10.1503/cmaj.211373 · Cited by 95 · see citing works
Self-citationSinus Tachycardia: a Multidisciplinary Expert Focused Review
Mayuga, K. A., Fedorowski, A., Ricci, F., Gopinathannair, R., Dukes, J. W., Gibbons, C., Hanna, P., Sorajja, D., Chung, M., Benditt, D., et al. (2022) · Circulation: Arrhythmia and Electrophysiology · doi:10.1161/circep.121.007960 · Cited by 59 · see citing works
Self-citationKnoop, I., Picariello, F., Jenkinson, E., Gall, N., Chisari, C., & Moss-Morris, R. (2023) · Autonomic Neuroscience · doi:10.1016/j.autneu.2022.103052 · Cited by 21 · see citing works
“…2017 ++++++ ++ +++ ++ +++ Ruska et al., 2018 ++++++ + ++ ++ Wells et al., 2020 ++++ + ++ ++ ++ Interventional studies (range) (0-10) (0-3) (0-7) (0-7) Bourne et al., 2021 ++++++++ + +++++ +++++ ++ Proof-of-concept trial Coffin et al., 2012 ++++++++ + +++++++ ++++ +++ Proof-of-concept trial…”
Uppal, J., Baker, J. R., Hira, R., Karalasingham, K., Ranada, S., Deol, P., Sheldon, R. S., & Raj, S. R. (2025) · Autonomic Neuroscience · doi:10.1016/j.autneu.2025.103281 · Cited by 13 · see citing works
Self-citation
- Authors
- Bourne, K. M., Sheldon, R. S., Hall, J., Lloyd, M., Kogut, K., Sheikh, N., Jorge, J., Ng, J., Exner, D. V., Tyberg, J. V., & Raj, S. R.
- Affiliations
- University of Calgary (CA)
- Corresponding author
- Raj, Satish R.
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 77
- Issue
- 3
- Pages
- 285-296
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W3121744392
- Cited by
- 76
- References
- 13
- Citations by year
- 2026: 10 · 2025: 20 · 2024: 15 · 2023: 11 · 2022: 13 · 2021: 7
- FWCI
- 10.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Cumming School of Medicine, University of Calgary
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- postural orthostatic tachycardia syndrome, compression garments, orthostatic intolerance, heart rate, stroke volume, systolic blood pressure, orthostatic symptoms, head-up tilt, abdominal compression
- MeSH terms
- Proof of Concept Study, Adult, Female, Heart Rate, Humans, Male, Cross-Over Studies, Postural Orthostatic Tachycardia Syndrome, Young Adult, Compression Bandages
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
