title: Orthostatic hypotension in diabetic patients-10-year follow-up study.
abstract: BACKGROUND
  Cardiovascular autonomic neuropathy in diabetics is a common but often underestimated and underdiagnosed complication of diabetes mellitus. One of the most clinical apparent forms of cardiovascular autonomic neuropathy is orthostatic hypotension.
  
  
  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.
  
  
  METHODS
  We retrospectively analyzed 187 patients with diabetes mellitus (60 patients with diabetes 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% of patients with diabetes type 1 (DM1) and in 32.3% of patients with diabetes type 2 (DM2). OH was positively associated with the prevalence of myocardial infarction in DM1 (OR=10.67) and with prevalence of stroke in DM2 (OR=3.33). There was also a strong association of OH and the prevalence of peripheral artery disease in both DM1 (OR=14.18) and DM2 (OR=3.26). Patients with both types of diabetes and OH had significantly higher prevalence of nephropathy (DM1 OR=8.68, DM2 OR=3.24), retinopathy (DM1 OR=8.09, DM2 OR=4.08) and peripheral neuropathy (DM1 OR=17.14, DM2 OR=7.51) Overall 10year mortality rate was higher in diabetic patients with OH.
  
  
  CONCLUSIONS
  Presence of OH in diabetics is associated with higher prevalence of macrovascular and microvascular complications of diabetes mellitus and also with higher 10-year mortality.
authors.affiliation: 2(nd) Department of Internal Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic. Electronic address: ludovitgaspar@gmail.com.
authors.forename: Ludovit
authors.initials: L
authors.lastname: Gaspar
authors.affiliation: 2(nd) Department of Internal Medicine, St. Anne's University Hospital and Masaryk University, Brno, Czech Republic. Electronic address: peter.kruzliak@savba.sk.
authors.forename: Peter
authors.initials: P
authors.lastname: Kruzliak
authors.affiliation: 2(nd) Department of Internal Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic.
authors.forename: Andrea
authors.initials: A
authors.lastname: Komornikova
authors.affiliation: 2(nd) Department of Internal Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Celecova
authors.affiliation: 2(nd) Department of Internal Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic.
authors.forename: Boris
authors.initials: B
authors.lastname: Krahulec
authors.affiliation: 2(nd) Department of Internal Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic.
authors.forename: David
authors.initials: D
authors.lastname: Balaz
authors.affiliation: 2(nd) Department of Internal Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic.
authors.forename: Peter
authors.initials: P
authors.lastname: Sabaka
authors.affiliation: 2(nd) Department of Internal Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Caprnda
authors.affiliation: 2(nd) Department of Internal Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic.
authors.forename: Marek
authors.initials: M
authors.lastname: Kucera
authors.affiliation: Department of Gastroenterology, Central University Hospital of Asturias (HUCA), Oviedo, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Rodrigo
authors.affiliation: Division of Clinical Nutrition, Faculty of Home Economics, Kyoritsu Women's University, Tokyo, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Uehara
authors.affiliation: 2(nd) Department of Internal Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic.
authors.forename: Andrej
authors.initials: A
authors.lastname: Dukat
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000150:complications / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D058065:Diabetic Cardiomyopathies / Q000150:complications / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000150:complications / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000150:complications / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D007024:Hypotension, Orthostatic / Q000150:complications / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D008875:Middle Aged; D009026:Mortality; D010044:Outpatient Clinics, Hospital; D015995:Prevalence; D051437:Renal Insufficiency / Q000150:complications / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D018154:Slovakia / Q000453:epidemiology
keywords: Diabetes mellitus; Diabetic cardiovascular autonomic neuropathy; Microvascular and macrovascular complications; Mortality; Orthostatic hypotension