[Vegetative neuropathy and pressure regulation in diabetics].
The present study was undertaken to evaluate the effects of autonomic cardiovascular neuropathy (ACN) on blood pressure control in diabetic patients.


METHODS
a nyctohemeral blood pressure (BP) monitoring (Spacelabs 5200) and an assessment of ACN, graded with a scoring system depending on usual test (Valsalva maneuver, heart response to deep breathing, blood pressure response to standing up and sustained handgrip) were performed in 90 normotensive male subjects. Thirty controls, age: 49 +/- 13 years, weight: 72 +/- 12 kg, height: 174 +/- 6 cm and 60 diabetic patients, type 1 or 2, age: 52 +/- 13 years, weight: 75 +/- 12 kg, height: 174 +/- 6 cm were recruited.


RESULTS
mean BP levels recorded on 24 hours (control: 117 +/- 13/75 +/- 9 mmHg, diabetic: 119 +/- 12/74 +/- 7 mmHg), BP variability measured with the coefficient of variation (SD/mean) (control: syst = 13 +/- 4, diast = 15 +/- 4; diabetic: syst = 12 +/- 3, diast = 14 +/- 4), differences between mean BP on day-time (9 a.m. - 8:30 p.m.) and mean BP on night-time (10:30 p.m. - 7:30 a.m.) (control: syst = 16 +/- 10 mmHg, diast = 11 +/- 8 mmHg; diabetic: syst = 13 +/- 10 mmHg, diast = 10 +/- 7 mmHg) are not statistically different. It is the same with heart rate. Two control and 11 diabetic subjects have impaired ACN tests. Among diabetic subjects, impairment of autonomic nervous cardiovascular system is correlated with abnormal BP pattern (loss of nocturnal fall, paradoxical nocturnal rise seen in 15 patients).(ABSTRACT TRUNCATED AT 250 WORDS)
Chanudet
X
X
Service de médecine interne et pathologie cardio-vasculaire, Ecole du Val de Grâce, hôpital militaire Bégin, Saint-Mandé.
Bauduceau
B
B
Ritz
P
P
Jolibois
P
P
Garcin
J M
JM
Larroque
P
P
Gautier
D
D
D000328:Adult; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000503:physiopathology*; D001794:Blood Pressure; D002940:Circadian Rhythm; D003925:Diabetic Angiopathies / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged
Neuropathie végétative et régulation tensionnelle chez le diabétique.