Abstract P465: Arterial Hypertension and Orthostatic Hypotension in Diabetic Patients

Abstract

Introduction: Diabetes mellitus is often associated not only with arterial hypertension. but also with orthostatic hypotension, which is one of the most clinical apparent forms of cardiovascular autonomic neuropathy. Objective: To retrospectively assess the association of the orthostatic hypotension (OH) with macrovascular and microvascular complications of diabetes mellitus and to determine its effect on mortality. Design and Methods: We retrospectively analysed 187 patients with diabetes mellitus (60 patients with type 1 and 127 patients with diabetes type 2). Patients were divided into groups according to presence or absence of OH and type of diabetes. Association of OH with macrovascular and microvascular complications was evaluated and the effect of OH on 10-year all-cause mortality was also assessed. Results: OH was present in 31.7 % (19 of 60) of patients with DM type 1 and 32.3 % (41 of 127) of patients with DM type 2. We found strong positive association between OH and arterial hypertension grade 3 ESH/ESC in DM1 42.1 % (8 of 19) and DM2 48.8 % (20 of 41). OH was positively associated with the prevalence of myocardial infarction in DM1 (OR=10.667) and with prevalence of stroke in DM2 (OR=3.335). There was also a strong association of OH and the prevalence of peripheral artery obliterative disease in both DM1 (OR=14.18) and DM2 (OR=3.263). Patients with both types of DM and OH had significantly higher prevalence of nephropathy (DM1 OR=8.680, DM2 OR=3.237), retinopathy (DM1 OR=8.095, DM2 OR=4.078) and peripheral neuropathy (DM1 OR=17.143, DM2 OR=7.506). Overall 10-year mortality rate was significantly higher in diabetic patients with OH, in DM1 group 31.6 % (6 of 19) and in DM2 group 31.7 % (13 of 41). Conclusion: Presence of orthostatic hypotension in diabetics is associated with higher prevalence of macrovascular and microvascular complications of diabetes mellitus and also with higher 10-year mortality.