Alteration in blood pressure and heart rate during standing-squatting-restanding test in patients with diabetic cardiovascular autonomic neuropathy / 中国糖尿病杂志

ABSTRACT

Objective To investigate the impact of diabetic cardiovascular autonomic neuropathy (DCAN) on heart rate and blood pressure during position change in patients with diabetes mellitus . Methods From January to June 2003 ,54 patients with diabetes mellitus were divided into diabetes mellitus group (n=31) and DCAN group (n= 23) according to the presence or absence of DCAN .22 healthy adults were selected as control group (n= 22 ) . The blood pressure and heart rate were measured continuously by digital arterial blood pressure monitoring system in the process of standing ,squatting and standing up .The changes of blood pressure and heart rate were observed at different time points and posture . Results Compared to NC group ,there were significant increased rangeability of changes in blood pressure [squatting diastolic pressure(17.9 ± 9.5)vs(24.1 ± 18.1) ,P< 0.05 ;standing systole pressure(-49.4 ± 20.4)vs(-73.5 ± 21.3)mmHg ,P<0.01 ;standing diastolic pressure(-32.2 ± 7.1) vs(-43.1 ± 15.8)mmHg ,P<0.05 or P<0.01] and significant decreased rangeability of changes in heart rate [squatting(-21.3 ± 13.0)vs(-6.5 ± 7.8)bpm ,P<0.05 or P<0.01 ;standing(34.6 ± 10.8)vs(11.4 ± 9.8)bpm ,P<0.05 or P<0.01] and remarkable longer recovery time especially in DCAN group (P<0.05 or P<0.01) during standing-squatting-standing test .There was no significant correlation between rangeability of blood pressure changes and heart rate in patients with diabetes . Conclusion There is impaired regulation of blood pressure and heart rate during postural changes in patients with diabetes , especially DCAN .