Relationship between arterial stiffness and blood pressure drop during the sit-to-stand test in patients with diabetes mellitus

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 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. 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. © 2017 japan atherosclerosis society.