Abstract Details

Title Initial Orthostatic Hypotension in Patients with Peripheral Diabetic Neuropathy

Topic Autonomic Disorders

Presentation(s) P03 - (-)

Poster/Presentation
Number 043

Objective

Background BACKGROUND: Patients were type 2 diabetics with clinical and neurophysiological evidence of distal sensory motor neuropathy evaluated by the Michigan Diabetic Neuropathy Scale as moderate to severe.

Design/Methods DESIGN/METHODS: Beat-to-beat systolic blood pressure (SBP) and inter-beat intervals (IBI) were measured with the Finapres device. Both groups were asked to stand up after 5-10 minutes of rest in supine position. We measured the basal supine heart rate (HR) in beats per minute, the basal SBP in mmHg, the peak increase of HR upon standing (HRp), the peak fall of SBP (SBPf), the time to the onset of recovery of the SBP (total fall time, TFt) and the time of recovery of SBP until a stable baseline.

Results RESULTS: Patients fulfilled the criteria of Wieling of a fall of SBP greater than 40 mmHg in the first 15 seconds after assuming the upright posture; however, most of them did not develop symptoms of cerebral hypoperfusion. The basal HR, SBP, TFt, the time of recovery of SBP and SBPf were significantly higher in patients than in controls. HRp upon standing was significantly decreased in patients than in controls.

Conclusions CONCLUSIONS: The increased TFt probably contributed to the fall in SBP. The delayed time of recovery of the SBP indicates a defect in the reflex vasoconstriction and therefore sympathetic damage to the blood vessels. The decreased in HR reflects cardiovagal damage and may also be a contributing factor to the immediate orthostatic hypotension observed in this study. Initial orthostatic hypotension in DN patients could be the earliest manifestation in asymptomatic patients of a defect in the baroreflex mediated vasosympathetic constriction.

Authors/Disclosures
Rodolfo C. Callejas-Rojas, MD (Neuro Sleep Klinik) PRESENTER	No disclosure on file
Bruno E. Vidal, MD (Instituto Nacional de Ciencias Médicas y Nutrición)	No disclosure on file
	No disclosure on file
Wolfgang Jost	Wolfgang Jost has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbive. Wolfgang Jost has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Stada. Wolfgang Jost has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. Wolfgang Jost has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Stada. Wolfgang Jost has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bial.

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