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Tan MP et al. – Carotid sinus hypersensitivity (CSH) was diagnosed in 25% of patients investigated with carotid sinus massage (CSM) at this specialist unit, lower than the prevalence of 39% reported for community–dwelling older individuals. This discrepancy may be explained by selection bias and demographic differences, but raises the possibility of CSH being an age–related epiphenomenon rather than a causal mechanism for syncope, drop attacks and unexplained falls. These observations have important implications for clinical practice and the development of future research strategies.

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