Postural blood pressure changes and associated factors in long-term Type 1 diabetes: Wisconsin Epidemiologic Study of Diabetic Retinopathy

Postural blood pressure changes and associated factors in long-term Type 1 diabetes: Wisconsin Epidemiologic Study of Diabetic Retinopathy

Author Hirai, Flavio E. Autor UNIFESP Google Scholar
Moss, Scot E. Google Scholar
Klein, Barbara E. K. Google Scholar
Klein, Ronald Google Scholar
Institution Univ Wisconsin
Universidade Federal de São Paulo (UNIFESP)
Abstract Purpose: To describe the frequency of orthostatic hypotension and hypertension and associations with risk factors in a cohort of persons with long-term Type 1 diabetes (n-440) participating in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Methods:);Evaluations included detailed medical history, electrocardiography (FCG), and laboratory tests. Blood pressure (BP) was measured in supine and standing positions. Standing decrease in systolic (SBP) or diastolic (DBP) BP of at least 20 or 10 mmHG, respectively, was defined as orthostatic hypotension; increase of SBP from <140 to >140 mmHg or DBP from <90 to >90 mmHg was defined as orthostatic hypertension. Results: Prevalence of orthostatic hypotension and orthostatic hypertension was 16.1% and 15.2%, respectively. Some ECG measurements of cardiac autonomic dysfunction were significantly associated with orthostatic hypotension. Association between SBP and orthostatic hypotension and orthostatic hypertension were significant [odds ratio, 1.02 (95% confidence interval, or CI, 1.01 1.05) and 1.02 (95% CI, 1.01 1.04), per 1 mmHg, respectively] after adjusting for confounders. Interaction between SBP and age was observed. SBP was significantly associated with orthostatic hypotension and orthostatic hypertension in people <= 40 years old [1.35 (1.02 1.78) and 1.12 (1.05-1.18), respectively]. Conclusions: Results showed that measurements derived from the ECG can help describe an individual at increased risk of having postural BP changes. Moreover, SBP was associated with postural BP changes among individuals who were <40 years of age with long-term Type I diabetes. (C) 2009 Elsevier Inc. All rights reserved.
Keywords Diabetes complications
Hypertension
Hypotension
Prevalence
Risk
Language English
Sponsor National Institutes of Health, Bethesda, MD
Mentor-Based Postdoctoral Fellowship Award
Grant number National Institutes of Health, Bethesda, MD: EY015117
Date 2009-03-01
Published in Journal of Diabetes and Its Complications. New York: Elsevier B.V., v. 23, n. 2, p. 83-88, 2009.
ISSN 1056-8727 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 83-88
Origin http://dx.doi.org/10.1016/j.jdiacomp.2008.01.002
Access rights Closed access
Type Article
Web of Science ID WOS:000263887300002
URI http://repositorio.unifesp.br/handle/11600/31356

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