Orthostatic hypotension in diabetic patients—10-year follow-up study

Gašpar, Ľudovít; Kružliak, Peter; Komornikova, Andrea; Celecova, Z; Krahulec, B; Breen, David P.; Sabaka, Peter; Čaprnda, Martin; Kucera, M; Rodrigo, Luís; Uehara, Yoshio; Dukát, Andrej

doi:10.1016/j.jdiacomp.2015.08.020

Cited by 37 publications

(30 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Edlow and colleagues found that healthy aging does not alter postural changes in frontal cortical perfusion. [21][22][23] We believe these findings add valuable information that may help to clarify previous results with respect to the relationship between OH and cognitive function. Brief episodes of cerebral hypoperfusion caused by sudden drops in BP may lead to hypoxia, with detrimental effects on the central nervous system via mechanisms such as oxidative stress and neuroinflammation.…”

Section: Discussionsupporting

confidence: 60%

“…OH, as a clinical manifestation of diabetic autonomic neuropathy, is usually irreversible and tough to manage with medications, 20 and is also a significant risk factor for syncope, cognitive decline, falls, cardiovascular disease, stroke, and all-cause morality. [21][22][23] We believe these findings add valuable information that may help to clarify previous results with respect to the relationship between OH and cognitive function. The majority of clinical neuropsychological tests are administered in the seated position.…”

Section: Discussionsupporting

confidence: 60%

See 1 more Smart Citation

Effects of orthostatic hypotension on cognition in type 2 diabetes mellitus

Zhang

Chi

Wang

et al. 2019

Annals of Neurology

View full text Add to dashboard Cite

Objective: To evaluate the effect of a decrease in blood pressure (BP) fulfilling the diagnostic criteria for orthostatic hypotension (OH) on performance in each domain of cognitive function in patients with type 2 diabetes mellitus using a cross-sectional and within-group design. Methods: Subjects were individuals without dementia and with type 2 diabetes mellitus, including 107 individuals without OH and 94 with OH (DMOH); 95 control participants were also included. BP was assessed in both the supine and standing positions. A detailed neuropsychological assessment was made in each posture for all subjects. Results: There were statistically significant differences between the patients without OH and the DMOH group with regard to some cognitive measures while supine. Standing posture exacerbated and broadened cognitive deficits in the DMOH group for all measures in the different domains of cognition including executive functioning, memory, visuospatial skills, information processing speed, and attention. When group-specific supine scores were used as baseline anchors, both the patients without OH and the DMOH group showed cognitive changes when transitioning from a supine to a standing, upright position, with the DMOH group exhibiting a wider range of neuropsychological deficits in memory, visuospatial skills, executive function, and sustained attention, as well as significant changes in information processing speed. Interpretation: These data demonstrate that type 2 diabetes mellitus patients with OH had transient, posturemediated cognitive deficits in excess of those found in diabetes mellitus without OH. Understanding the effects of OH on cognition due to autonomic failure is important, particularly as clinical assessments and neuroimaging collect data only in the seated or supine positions. ANN NEUROL 2019;86:754-761 View this article online at wileyonlinelibrary.com.

show abstract

Section: Discussionsupporting

confidence: 60%

Section: Discussionsupporting

confidence: 60%

Effects of orthostatic hypotension on cognition in type 2 diabetes mellitus

Zhang

Chi

Wang

et al. 2019

Annals of Neurology

View full text Add to dashboard Cite

show abstract

“…A 10-year follow-up retrospective analysis of data collected from the outpatients of Diabetology office in Slovakia [36] on Orthostatic hypotension in diabetic patients found that diabetes mellitus (both type 1 and type 2) was positively associated with the presence of OH. The study done among diabetics in Japan [37] found prevalence of OH to be 7% and their multivariate analysis also revealed that the association remained significant after adjustment for the treatment and duration of diabetes, age, sex and body mass index. The study done in Morocco [39] to determine if OH is more prevalent in hypertensive diabetics than in normotensive diabetics, OH was found in 42.3% of hypertensive diabetics while 13.6% of normotensive diabetics had OH with a statistically significant association.…”

Section: Discussionmentioning

confidence: 97%

Prevalence of Orthostatic Hypotension in the Elderly in Anambra State

Kenechukwu¹,

Christian²,

Ifeoma³

et al. 2018

SJCM

View full text Add to dashboard Cite

Background: Orthostatic hypotension is a condition in which blood pressure drops abnormally when a person stands up from a sitting or a lying down position. It is a sustained reduction of systolic blood pressure of at least 20mmHg or diastolic blood pressure of at least 10mmHg within three minutes of standing or a head-up tilt to at least 60 degrees on a tilt table. Orthostatic hypotension has been observed in all age groups, but it occurs more in the elderly, especially in persons who are sick and frail. The burden of Orthostatic hypotension on public health is substantial, with a prevalence of 7% to 55% in the elderly and is higher in those with risk factors. The diagnosis of orthostatic hypotension is therefore important in the treatment of elderly patients. Methods: This cross-sectional study was designed to evaluate the prevalence of orthostatic hypotension in community-dwelling elderly in Anambra State, Nigeria. The study population was a 400 persons aged 60 years and older selected by multistage sampling method. Results: The total prevalence of OH was 14.8% (n=59). The prevalence of OH was related to presence of hypertension, diabetes, raised supine systolic and raised supine diastolic BP (P ≤ 0.05). Diabetics [OR: 4.689 (95% CI: 1.121-19.984)] and those with supine diastolic hypertension [OR: 1.699 (95% CI: 0.401-7.209)] were more likely to have OH. Conclusion: The prevalence of orthostatic hypotension in 60 years and older adults in Anambra State was high and was found to be higher in hypertensives and diabetics.

show abstract

“…Autonomous nervous system was reported to be essential for orthostatic reflex and dysfunction of this system usually results in OH . Some pathologies such as diabetes, alpha‐synucleinopathies, and sarcoidosis are common causes for autonomic neuropathy, and OH is prevalent among these diseases . Furthermore, these pathologies may also impair cognitive function by various mechanisms .…”

Section: Discussionmentioning

confidence: 99%

“…40 Some pathologies such as diabetes, alpha-synucleinopathies, and sarcoidosis are common causes for autonomic neuropathy, and OH is prevalent among these diseases. 41,42 Furthermore, these pathologies may also impair cognitive function by various mechanisms. [43][44][45][46] There are studies examining the relationship between OH and cognitive function among diabetes, alpha-synucleinopathies, and sarcoidosis participants.…”

Section: Discussionmentioning

confidence: 99%

The association between orthostatic hypotension and dementia: A meta‐analysis of prospective cohort studies

Min

Shi

Sun

et al. 2018

Int J Geriat Psychiatry

View full text Add to dashboard Cite

Objectives As for the association between orthostatic hypotension (OH) and dementia, results of published studies are inconsistent; therefore, current substantive conclusions have yet been obtained. This meta‐analysis was conducted in hopes of producing progress in this topic. Methods A systematic database search was performed towards electronic databases including Chinese Biomedical Database, PubMed, Web of Science, Wiley Online Library, ScienceDirect, and the Cochrane Library. Five prospective cohort studies were included. Summary hazard ratio (HR) estimates with 95% confidence intervals (CIs) were calculated by random‐effects model. Statistical heterogeneity was assessed with the Cochran Q test and I2 statistic. A sensitivity analysis was also conducted in this meta‐analysis. Results A 22.4% higher prevalence of dementia in subjects with OH was obtained (adjusted pooled HR was 1.224; 95% CI: 1.106‐1.354; P < .001). This meta‐analysis also showed significant associations between OH and 2 dementia subtypes: Alzheimer disease (adjusted pooled HR was 1.175; 95% CI: 1.022‐1.351; P = .023) and Vascular dementia (adjusted pooled HR was 1.403; 95% CI: 1.042‐1.889; P = .026), respectively. Conclusions Orthostatic hypotension is positively associated with the overall prevalence of dementia, and it may contribute to the prevalence of Alzheimer disease and Vascular dementia as well.

show abstract

Orthostatic hypotension in diabetic patients—10-year follow-up study

Cited by 37 publications

References 31 publications

Effects of orthostatic hypotension on cognition in type 2 diabetes mellitus

Effects of orthostatic hypotension on cognition in type 2 diabetes mellitus

Prevalence of Orthostatic Hypotension in the Elderly in Anambra State

The association between orthostatic hypotension and dementia: A meta‐analysis of prospective cohort studies

Contact Info

Product

Resources

About