title: Relationship between Arterial Stiffness and Blood Pressure Drop During the Sit-to-stand Test in Patients with Diabetes Mellitus.
abstract: OBJECTIVE
  Patients with orthostatic hypotension (OH) have high arterial stiffness. Patients with diabetes mellitus (DM) often have cardiac autonomic neuropathy that leads to OH; however, whether OH is an indicator of arterial stiffness progression is unclear. We aimed to investigate whether the cardio-ankle vascular index (CAVI) varies between DM patients with and without OH using the sit-to-stand test (STST).
  
  
  METHODS
  One hundred and fifty-nine patients with DM underwent CAVI assessment and blood pressure (BP) and heart rate change evaluation during the STST. OH was defined as a decline in systolic BP (SBP) and/or diastolic BP of at least 20 mmHg or 10 mmHg, respectively, in the initial and late upright positions compared with that in the sitting position.
  
  
  RESULTS
  OH was diagnosed in 42 patients (26.4%). DM patients with OH had significantly higher CAVI (9.36±1.15 versus 8.89±1.18, p=0.026) than those without OH. CAVI was significantly inversely correlated with systolic and diastolic BP changes (R=－0.347, p＜0.001 and R=－0.314, p＜0.001, respectively) in the initial upright position. Multivariate regression analysis revealed that age, SBP changes, and low frequency component in the initial upright position were independent determinants of CAVI.
  
  
  CONCLUSIONS
  Patients with DM having large BP drops occurring when moving from sitting to standing have high arterial stiffness. A significant BP drop during the STST necessitates careful evaluation of advanced arterial stiffness in patient with DM.
authors.affiliation: Division of Nephrology, Yokosuka City Hospital.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Fujikawa
authors.forename: Hideo
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Koichiro
authors.initials: K
authors.lastname: Sumida
authors.forename: Shota
authors.initials: S
authors.lastname: Suzuki
authors.forename: Minako
authors.initials: M
authors.lastname: Kagimoto
authors.forename: Yuki
authors.initials: Y
authors.lastname: Okuyama
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Ehara
authors.forename: Mari
authors.initials: M
authors.lastname: Katsumata
authors.forename: Megumi
authors.initials: M
authors.lastname: Fujita
authors.forename: Akira
authors.initials: A
authors.lastname: Fujiwara
authors.forename: Sanae
authors.initials: S
authors.lastname: Saka
authors.forename: Keisuke
authors.initials: K
authors.lastname: Yatsu
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kuji
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Hirawa
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Toya
authors.forename: Gen
authors.initials: G
authors.lastname: Yasuda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umemura
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology*; D015415:Biomarkers / Q000032:analysis*; D001794:Blood Pressure / Q000502:physiology*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000378:metabolism; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006339:Heart Rate; D006801:Humans; D007024:Hypotension, Orthostatic / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology; D011379:Prognosis; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness / Q000502:physiology*
chemical_list: D015415:Biomarkers