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Artery blood pressure oscillation after active standing up: an indicator of sympathetic function in diabetic patients

Lindqvist, A; Torffvit, Ole LU ; Rittner, Ralf LU ; Agardh, Carl-David LU and Pahlm, Olle LU (1997) In Clinical Physiology 17(2). p.159-169
Abstract
Dynamic artery blood pressure (Finapres) response to active standing up, normally consisting of initial rise, fall and recovery above the baseline (overshoot), was compared with the early steady-state artery blood pressure level to measure sympathetic vasomotor function in healthy subjects (n = 23, age 35 +/- 9 years; mean +/-SD) and in type I diabetic patients without autonomic neuropathy (AN) (group 1: n = 18, 38 +/- 13 years), with AN but no cardiovascular drugs (group 2a: n = 7, 44 +/- 11 years) and with both AN and cardiovascular drugs (group 2b: n = 10, 47 +/- 7 years). Systolic and diastolic overshoot were similar in the control (15 +/- 13/15 +/- 11 mmHg) and group 1 subjects. Systolic overshoot disappeared in 57% of patients in... (More)
Dynamic artery blood pressure (Finapres) response to active standing up, normally consisting of initial rise, fall and recovery above the baseline (overshoot), was compared with the early steady-state artery blood pressure level to measure sympathetic vasomotor function in healthy subjects (n = 23, age 35 +/- 9 years; mean +/-SD) and in type I diabetic patients without autonomic neuropathy (AN) (group 1: n = 18, 38 +/- 13 years), with AN but no cardiovascular drugs (group 2a: n = 7, 44 +/- 11 years) and with both AN and cardiovascular drugs (group 2b: n = 10, 47 +/- 7 years). Systolic and diastolic overshoot were similar in the control (15 +/- 13/15 +/- 11 mmHg) and group 1 subjects. Systolic overshoot disappeared in 57% of patients in group 2a (-1 +/- 9 mmHg; P < 0.03), whereas artery blood pressure still overshot in diastole (8 +/- 7 mmHg; NS). Systolic overshoot disappeared in all patients in group 2b (-22 +/- 22 mmHg; P < 0.0006) and diastolic overshoot disappeared in 60% of these patients (-6 +/- 16 mmHg; P = 0.0006). Systolic early steady-state level was not lower in group 2a than in group 1 (NS), but it was impaired in group 2b (P < 0.006), in which six diabetic patients had a pathological response beyond the age-related reference values. There was a strong association between the overshoot and steady-state levels (P for chi 2 < 0.001, n = 58). Overshoot of the control subjects and patients in group 2b correlated to their respective steady-state blood pressure levels (r > or = 0.76; P < or = 0.001). In conclusion, baroreceptor reflex-dependent overshoot of the artery blood pressure after active standing up diminishes with the development of AN and it is associated with the early steady-state level of the artery blood pressure. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
artery blood pressure, asympathicotonic response, autonomic neuropathy, diabetes mellitus, baroreflex, blood pressure overshoot, Finapres, orthostatic test
in
Clinical Physiology
volume
17
issue
2
pages
159 - 169
publisher
Wiley-Blackwell
external identifiers
  • pmid:9156962
  • scopus:0030993862
ISSN
1365-2281
DOI
10.1046/j.1365-2281.1997.02222.x
language
English
LU publication?
yes
id
7e0c647e-9deb-4fdc-80b4-51b6ae813f06 (old id 1111713)
date added to LUP
2008-07-18 11:14:33
date last changed
2017-01-01 04:40:06
@article{7e0c647e-9deb-4fdc-80b4-51b6ae813f06,
  abstract     = {Dynamic artery blood pressure (Finapres) response to active standing up, normally consisting of initial rise, fall and recovery above the baseline (overshoot), was compared with the early steady-state artery blood pressure level to measure sympathetic vasomotor function in healthy subjects (n = 23, age 35 +/- 9 years; mean +/-SD) and in type I diabetic patients without autonomic neuropathy (AN) (group 1: n = 18, 38 +/- 13 years), with AN but no cardiovascular drugs (group 2a: n = 7, 44 +/- 11 years) and with both AN and cardiovascular drugs (group 2b: n = 10, 47 +/- 7 years). Systolic and diastolic overshoot were similar in the control (15 +/- 13/15 +/- 11 mmHg) and group 1 subjects. Systolic overshoot disappeared in 57% of patients in group 2a (-1 +/- 9 mmHg; P &lt; 0.03), whereas artery blood pressure still overshot in diastole (8 +/- 7 mmHg; NS). Systolic overshoot disappeared in all patients in group 2b (-22 +/- 22 mmHg; P &lt; 0.0006) and diastolic overshoot disappeared in 60% of these patients (-6 +/- 16 mmHg; P = 0.0006). Systolic early steady-state level was not lower in group 2a than in group 1 (NS), but it was impaired in group 2b (P &lt; 0.006), in which six diabetic patients had a pathological response beyond the age-related reference values. There was a strong association between the overshoot and steady-state levels (P for chi 2 &lt; 0.001, n = 58). Overshoot of the control subjects and patients in group 2b correlated to their respective steady-state blood pressure levels (r &gt; or = 0.76; P &lt; or = 0.001). In conclusion, baroreceptor reflex-dependent overshoot of the artery blood pressure after active standing up diminishes with the development of AN and it is associated with the early steady-state level of the artery blood pressure.},
  author       = {Lindqvist, A and Torffvit, Ole and Rittner, Ralf and Agardh, Carl-David and Pahlm, Olle},
  issn         = {1365-2281},
  keyword      = {artery blood pressure,asympathicotonic response,autonomic neuropathy,diabetes mellitus,baroreflex,blood pressure overshoot,Finapres,orthostatic test},
  language     = {eng},
  number       = {2},
  pages        = {159--169},
  publisher    = {Wiley-Blackwell},
  series       = {Clinical Physiology},
  title        = {Artery blood pressure oscillation after active standing up: an indicator of sympathetic function in diabetic patients},
  url          = {http://dx.doi.org/10.1046/j.1365-2281.1997.02222.x},
  volume       = {17},
  year         = {1997},
}