Orthostatic hypotension had a pooled prevalence of 24% (95% CI 19-28%) in diabetic patients, with diabetic nephropathy (OR 2.37) and hypertension (OR 1.02) identified as significant risk factors.
Meta-Analysis (n=13,772)
What is the prevalence, what are the risk factors, and what is the prognosis of orthostatic hypotension in patients with diabetes mellitus?
Orthostatic hypotension affects approximately 24% of diabetic patients, is driven by factors like poor glycemic control and nephropathy, and portends a higher risk of mortality and cardiovascular events.
BACKGROUND: Orthostatic hypotension (OH) is a major clinical sign of cardiovascular autonomic dysfunction in diabetic patients. Our aim was to quantitatively evaluate the prevalence and risk factors of OH in patients with diabetes mellitus (DM) and assess its prognosis. METHODS: A comprehensive search of the PubMed, Embase, China National Knowledge Infrastructure, VIP Chinese Journal, Wanfang, and SINOMED databases was conducted for related published work up to September 25, 2016, and manually searched eligible studies from the references in accordance with the inclusion criteria. RESULTS: We included 21 studies in the analysis, with a total sample size of 13,772. The pooled prevalence of OH in DM was 24% (95% confidence interval CI: 19-28%). Potential risk factors, that is, glycosylated hemoglobin A (HbA1c) (odds ratio OR, 1.13, 95% CI, 1.07-1.20), hypertension (OR, 1.02, 95% CI, 1.01-1.02), and diabetic nephropathy (OR, 2.37, 95% CI, 1.76-3.19), were significantly associated with OH in DM. In addition, the prognosis of OH in DM was associated with higher risk of total mortality and cardiovascular events. CONCLUSION: The pooled prevalence of OH in DM appears high. HbA1c, hypertension, and diabetic nephropathy are risk factors for OH in DM. OH indicates poor prognosis in diabetic patients. Attention should be focused on diabetic patients with the stated risk factors to prevent OH.
Zhou et al. (Fri,) conducted a meta-analysis in Diabetes mellitus (n=13,772). Risk factors (HbA1c, hypertension, diabetic nephropathy) was evaluated on Prevalence of orthostatic hypotension (95% CI 19-28). Orthostatic hypotension had a pooled prevalence of 24% (95% CI 19-28%) in diabetic patients, with diabetic nephropathy (OR 2.37) and hypertension (OR 1.02) identified as significant risk factors.
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