title: Autonomic cardiovascular neuropathy in Sjögren's syndrome. A controlled study.
abstract: OBJECTIVE
  To test patients with primary Sjögren's syndrome (SS) for evidence of autonomic neuropathy.
  
  
  METHODS
  Thirty-two patients with primary SS and 22 age and sex matched healthy individuals were asked specific questions about symptoms suggestive of autonomic neuropathy, and were subjected to a battery of 5 cardiovascular tests: response of blood pressure to sustained hand grip, Valsalva maneuver, heart rate response to deep breathing, and heart rate and blood pressure response to standing up. The chi-squared test with Yates' correction and 95% confidence intervals were used for statistical analysis of the results.
  
  
  RESULTS
  Sixteen patients (50%) had symptoms of autonomic neuropathy when specifically asked versus none of the controls (p < 0.0005). The frequency of abnormal responses to the tests was 68.8% in patients and 12.7% in controls (p < 0.0001). Severe autonomic cardiovascular neuropathy was found in 87.5% of the patients but in none of the healthy individuals (p < 0.0001).
  
  
  CONCLUSIONS
  Our results suggest that autonomic neuropathy is a feature of a significant portion of the SS population, and such patients should have appropriate evaluation. Similarly, patients with unexplained autonomic neuropathy should be investigated for evidence of SS.
authors.affiliation: Department of Medicine, Patras University School of Medicine, Greece.
authors.forename: A P
authors.initials: AP
authors.lastname: Andonopoulos
authors.forename: J
authors.initials: J
authors.lastname: Christodoulou
authors.forename: C
authors.initials: C
authors.lastname: Ballas
authors.forename: A
authors.initials: A
authors.lastname: Bounas
authors.forename: D
authors.initials: D
authors.lastname: Alexopoulos
mesh_terms: D000328:Adult; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000503:physiopathology*; D001794:Blood Pressure; D002319:Cardiovascular System / Q000503:physiopathology*; D016022:Case-Control Studies; D003627:Data Interpretation, Statistical; D015444:Exercise; D005260:Female; D006334:Heart Function Tests; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture; D012859:Sjogren's Syndrome / Q000503:physiopathology*; D014636:Valsalva Maneuver