What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Diabetes mellitus (n=193). Intervention: Pulse wave velocity > 8.25 m/s vs. Pulse wave velocity ≤ 8.25 m/s. Primary outcome: Presence of orthostatic hypotension (OR 18.7, 95% CI 6.20-56.48, p=<0.001).

What question did this study set out to answer?

The aim is to evaluate factors linked to orthostatic hypotension and its connection with arterial stiffness in diabetes mellitus patients.

May 8, 2026Open Access

Orthostatic hypotension as a marker of increased arterial stiffness in diabetes mellitus

Q: What are the key findings of this study?

In patients with diabetes mellitus, increased arterial stiffness (pulse wave velocity > 8.25 m/s) was independently associated with the presence of orthostatic hypotension (OR 18.7).

Q: What does this research mean for the field?

In patients with diabetes mellitus, increased arterial stiffness is independently associated with the presence of orthostatic hypotension. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

In patients with diabetes mellitus, increased arterial stiffness (pulse wave velocity > 8.25 m/s) was independently associated with the presence of orthostatic hypotension (OR 18.7).

Key Points

The aim is to evaluate factors linked to orthostatic hypotension and its connection with arterial stiffness in diabetes mellitus patients.
Single-center cross-sectional study with 193 patients with diabetes mellitus.
Measured orthostatic blood pressure and arterial stiffness using PWV with the Mobil-O-Graph device.
Performed logistic regression analyses to determine factors associated with orthostatic hypotension.
Orthostatic hypotension was identified in 29% of patients (56 out of 193).
Patients with OH exhibited higher arterial stiffness parameters, including increased PWV and augmentation index.
Female sex, older age, diabetic neuropathy, and PWV were independently associated with OH.

Study Design

Type

Cross-Sectional (n=193)

Multicenter

Structured PICO

Is orthostatic hypotension associated with increased arterial stiffness in patients with diabetes mellitus?

Population

193 patients with diabetes mellitus

Outcome

Factors associated with orthostatic hypotension and the relationship between arterial stiffness parameters and orthostatic hypotensionsurrogate

In patients with diabetes mellitus, orthostatic hypotension is independently associated with increased arterial stiffness and diabetic neuropathy.

Main Result

Effect estimate: OR 18.7 (95% CI 6.20-56.48)

p-value: p=<0.001

Limitations

Single-center design may limit generalizability
Exclusion of patients with eGFR < 60 mL/min/1.73 m² limits applicability to advanced chronic kidney disease
Diabetic neuropathy defined based on symptoms without objective confirmatory testing
Mobil-O-Graph device does not represent the gold-standard carotid–femoral PWV measurement
Standard autonomic function tests were not performed
Relatively small number of patients with orthostatic hypotension (n = 56) may affect precision of estimates
Cross-sectional design precludes establishing causal relationships

Abstract

BACKGROUND: Orthostatic hypotension (OH) is associated with adverse cardiovascular outcomes and may reflect underlying autonomic and vascular dysfunction. Arterial stiffness is a key determinant of cardiovascular risk; however, its relationship with OH in patients with diabetes mellitus (DM) remains unclear. OBJECTIVE: To evaluate factors associated with OH and investigate the relationship between arterial stiffness parameters and OH in patients with DM. METHODS: This single-center cross-sectional study included 193 patients with DM. Orthostatic blood pressure was measured in the supine position and 3 min after standing. Arterial stiffness was assessed using oscillometric pulse wave velocity (PWV) and related parameters with the Mobil-O-Graph device. Clinical, laboratory, and medication data were analyzed. Logistic regression analyses were performed to identify factors associated with OH. RESULTS: OH was present in 56 patients (29%). Patients with OH had significantly higher central blood pressure and arterial stiffness parameters, including PWV, augmentation pressure, and augmentation index. In multivariate analysis, female sex, older age, diabetic neuropathy, and PWV were independently associated with OH. PWV remained significantly associated with OH after adjustment for confounders. No significant differences were observed between groups regarding antihypertensive medication classes. CONCLUSION: In patients with DM, OH is independently associated with increased arterial stiffness and diabetic neuropathy. These findings suggest a link between orthostatic blood pressure dysregulation and adverse vascular characteristics. Prospective studies are needed to clarify causal relationships and clinical implications.

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