Session: SUN 807-838-Diabetes - Diagnosis, Complications & Outcomes
Poster Board SUN-810
Cardiovascular autonomic neuropathy is associated with significant morbidity and mortality in patients with type 2 diabetes (T2D) with orthostatic hypotension being the most dangerous complication.
Orthostatic hypertention (OHT) has been reported to occur, but studies assessing its effects on health outcomes especially in elderly and diabetics are scarce. The definition, prevalence and its effect on cardiovascular safety is still controversial.
The aim of the present study was to determine the prevalence of OHT in enderly patients with type 2 diabetes and its association with metabolic factors, echocardiographic parameters, and chronic complications.
An analytic cross-sectional study in 97 diabetic patients aged > 60 yr (mean 68,97 +- 6,80 yr), normotensive or hypertensive on angiotensin converting enzyme inhibitors, angiotensin receptor blockers or calcium channel blockers only. OHT was defined as a ≥ 10mmHg increase in systolic blood pressure after 4 minutes in standing against the sitting position
Mean duration of diabetes was 12,23 yr (±8,34) and HbA1C was 7,9% (±1,71). The prevalence of OHT was 20,6%. Mean BMI was significantly higher in pacients with OHT in comparation with those without it (29.80 ±4.10 vs. 27.51 ±3.98kg/m2, p=0.026) as was hip circumference (106.00 ±13.16 vs. 100.59 ±8.56cm, p=0.029). There were no statisticaly significant difference between the two groups in other metabolic paramethers such as waist circumference, serum trigliceryde, HDL-c and HbA1C.
Among the 68 patients who did an echocardiographicy examination 27% from those who had OHT had increases in index left atrial volume (iLAV)in comparation with 75% of those who did not have OHT (p=0,004). The average iLAV of patients with OHT was significantly lower in comparation to those without OHT (26.27 ±6.37 vs. 32.65 ±7.54 respectively, p=0.011).
Our data sugests some protective cardiac effect of postural increases in blood pressure in long standing T2D.
Nothing to Disclose: PM, DQ, JM, MAS, JG, AD, ACT, FFB
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