Relationship between Arterial Stiffness and Blood Pressure Drop During the Sit-to-stand Test in Patients with Diabetes Mellitus

Abstract

Aim: 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 cardioankle 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.Conclusion: 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.

Changes in fatigue, autonomic functions, and blood biomarkers due to sitting isometric yoga in patients with chronic fatigue syndrome

“…Electrodes were placed on both wrists. Beat-to-beat HR was assessed on the ECG, and HRV indices and respiratory rate were measured using the “Kiritsu Meijin” (Crosswell Co., Inc., Yokohama, Japan) [ 33 ], which included a HR monitor LRR-03 (GMS, Tokyo, Japan). The majority of previous studies have used spectral techniques based on the Fast Fourier Transform (FFT).…”

White-coat effect on orthostatic hypotension: a nationwide survey of Japanese general practitioners

“…Third, in principle, when measuring BP while standing, it is recommended to measure it at 1 and 3 min after standing [27]. However, a study on patients with diabetes reported that BP values immediately after standing are the most sensitive markers of arterial stiffness compared with BP values afterward [28]. In addition, since symptoms associated with OH, such as dizziness and falling, are often seen immediately after standing, BP measurements in the present study were taken both immediately and 1 min after standing.…”

The longitudinal effects of seated isometric yoga on blood biomarkers, autonomic functions, and psychological parameters of patients with chronic fatigue syndrome: a pilot study

“…Electrodes were placed on both wrists. Beat-to-beat HR was assessed on the electrocardiogram, and HRV indices and respiratory rate were measured using the software program Kiritsu Meijin (Crosswell Co., Inc., Yokohama, Japan) [40] and the HR monitor LRR-03 (GMS, Tokyo, Japan). The majority of previous studies have used spectral techniques based on the fast Fourier transform algorithm, which is insufficient to estimate the precise power spectral density from short time series data.…”