Diabetic Cardiovascular Autonomic Neuropathy, the Handgrip Test and Ambulatory Blood Pressure Monitoring Parameters: Are There Any Diagnostic Implications?
| Autor: | Orsolya Vági, Ildikó Istenes, Magdolna Békeffy, Anna Erzsébet Körei, Karolina Schnabel, Zsuzsanna Putz, Miklós Soma Kempler, Noémi Hajdú, Péter Kempler |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Ambulatory blood pressure hypertension Diastole lcsh:Medicine Isometric exercise 030204 cardiovascular system & hematology Article 03 medical and health sciences 0302 clinical medicine Internal medicine Diabetes mellitus medicine Heart rate variability 030212 general & internal medicine business.industry lcsh:R General Medicine Gold standard (test) medicine.disease Blood pressure Cardiology handgrip test Complication business human activities cardiovascular autonomic neuropathy |
| Zdroj: | Journal of Clinical Medicine Volume 9 Issue 10 Journal of Clinical Medicine, Vol 9, Iss 3322, p 3322 (2020) |
| ISSN: | 2077-0383 |
| DOI: | 10.3390/jcm9103322 |
| Popis: | Cardiovascular autonomic neuropathy (CAN) is a common complication of diabetes mellitus. Cardiovascular reflex tests (CARTs) are the gold standard in the diagnosis of CAN, but the handgrip test is no longer recommended to be performed. Previously, the inverse association between the presence of hypertension and handgrip test abnormality was demonstrated and hypertension as major cause for excessive diastolic blood pressure rise during handgrip testing in diabetic individuals proposed. The aim of the present study is to describe more precisely the association between handgrip test and hypertension by performing ambulatory blood pressure monitoring (ABPM) among diabetic patients. A more comprehensive evaluation of the relationship between cardiovascular autonomic function, hypertension and the handgrip test was targeted using heart rate variability (HRV) analysis. Our study involved 163 patients with diabetes. Cardiovascular autonomic neuropathy was assessed by the CARTs and sustained handgrip test was performed. All patients underwent ABPM and HRV analysis well. CAN was diagnosed in 69 patients. Significant associations were found between the diastolic blood pressure increase in response to handgrip exercise and the 24-h (rho = 0.245, p = 0.003), daytime (rho = 0.230, p = 0.005) and night-time (rho = 0.230, p = 0.006) mean systolic and 24-h diastolic (rho = 0.176, p = 0.034) blood pressure values, systolic blood pressure load (rho = 0.252, p = 0.003) and systolic (rho = 0.236, p = 0.005) and diastolic (rho = 0.165, p = 0.047) hyperbaric impacts. Higher values of ambulatory blood pressure monitoring parameters are associated with greater increases in diastolic blood pressure during isometric handgrip exercise. Diastolic blood pressure elevations during the handgrip test are also correlated, in order to diminished heart rate variability parameters attributable to parasympathetic dysfunction highlighting the pivotal role of sympathetic overactivity in evolving handgrip test results. Our study provides further evidence on the inverse association between handgrip test abnormality and hypertension in diabetic patients. |
| Databáze: | OpenAIRE |
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