2020
DOI: 10.3390/jcm9103322
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Diabetic Cardiovascular Autonomic Neuropathy, the Handgrip Test and Ambulatory Blood Pressure Monitoring Parameters: Are There Any Diagnostic Implications?

Abstract: Cardiovascular autonomic neuropathy (CAN) is a common complication of diabetes mellitus. Cardiovascular reflex tests (CARTs) are the gold standard in the diagnosis of CAN, but the handgrip test is no longer recommended to be performed. Previously, the inverse association between the presence of hypertension and handgrip test abnormality was demonstrated and hypertension as major cause for excessive diastolic blood pressure rise during handgrip testing in diabetic individuals proposed. The aim of the present st… Show more

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Cited by 8 publications
(5 citation statements)
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“…The fact that the study group's BP went up a lot during the cold pressor test and the isometric hand grip exercise test shows that people with T2DM have more sympathetic activity [ 16 , 17 ]. This is consistent with the notion that chronic hyperglycemia leads to increased sympathetic tone, contributing to the risk of hypertension and cardiovascular complications [ 17 ].…”
Section: Discussionmentioning
confidence: 99%
“…The fact that the study group's BP went up a lot during the cold pressor test and the isometric hand grip exercise test shows that people with T2DM have more sympathetic activity [ 16 , 17 ]. This is consistent with the notion that chronic hyperglycemia leads to increased sympathetic tone, contributing to the risk of hypertension and cardiovascular complications [ 17 ].…”
Section: Discussionmentioning
confidence: 99%
“…Orthostatic hypotension was defined by a fall in systolic blood pressure of ≥20 mm Hg (≥30 mm Hg in patients with hypertension) and/or a fall in diastolic blood pressure of ≥10 mm Hg within 3 min of standing [ 28 , 29 ]. The rise in diastolic blood pressure after an isometric hand-grip exercise (maintenance of 30% of the maximal hand grip strength for 3–4 min) using a hand dynamometer was recorded [ 28 , 30 , 31 ]. A rise in diastolic blood pressure of <16 mm Hg was considered abnormal [ 28 , 31 ].…”
Section: Methodsmentioning
confidence: 99%
“…The rise in diastolic blood pressure after an isometric hand-grip exercise (maintenance of 30% of the maximal hand grip strength for 3–4 min) using a hand dynamometer was recorded [ 28 , 30 , 31 ]. A rise in diastolic blood pressure of <16 mm Hg was considered abnormal [ 28 , 31 ]. The heart rate variability (heart rate during expiration: heart rate during inspiration) was recorded by electrocardiogram and a ratio of ≤1.1 was considered abnormal [ 28 , 32 , 33 ].…”
Section: Methodsmentioning
confidence: 99%
“…Saját adataink alapján a 'handgrip' teszt igen gyenge szenzitivitással és mérsékelt specificitással rendelkezik a diabeteshez társuló szimpatikus károsodás kimutatásában, és a mért értékeket jelentősen befolyásolja a hypertonia fennállása [33]. Sőt újabban a kézizomfeszítést kísérő diastolés vérnyomás-emelkedés mértéke és a hypertonia 24 órás ambuláns vérnyomás-monitorozási paraméterei között is szignifikáns összefüggés adódott [34], és az előbbi mind diabeteses, mind diabetestől mentes betegekben összefüggést mutatott a balkamrahypertrophia paramétereivel. Mindez arra utal, hogy a teszt a hypertoniával járó túlzott szimpatikus aktivitás markere.…”
Section: A Cardiovascularis Autonóm Neuropathia Diagnózisaunclassified