Orthostatic blood pressure dysregulation is highly prevalent in diabetic patients, with orthostatic hypertension associated with longer disease duration and orthostatic hypotension linked to poorer glycemic control.
Abstract Background: Orthostatic blood pressure (BP) dysregulation is a marker of cardiac autonomic neuropathy in diabetes. This study examined the prevalence and clinical correlates of orthostatic hypertension and hypotension in diabetic outpatients. Methods: A cross-sectional study enrolled 142 diabetic patients (18–60 years) at a tertiary care centre. Supine and standing BP were recorded at 3 min of standing. Participants were categorised as orthostatic normotension, hypertension or hypotension. ANOVA, Fisher’s exact test, Tukey’s post hoc and Pearson’s correlation were used. The manuscript was prepared in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results: Of 142 participants (mean age 58.6 ± 12.5 years), 42 (29.5%) had orthostatic hypertension and 37 (26%) orthostatic hypotension. Groups differed significantly in diabetes duration, glycated haemoglobin (HbA1c) and Toronto Clinical Scoring System scores. Diabetes duration correlated with systolic BP change ( r = 0.262, P = 0.0016); elevated HbA1c was associated with orthostatic hypotension. Conclusion: Orthostatic hypertension was more prevalent and associated with longer disease duration. Orthostatic hypotension was linked to poorer glycaemic control and advanced neuropathy. Routine orthostatic BP assessment is recommended for all diabetic patients.
Banerjee et al. (Tue,) studied this question.