PMID- 23254593
OWN - NLM
STAT- MEDLINE
DCOM- 20140121
LR  - 20130612
IS  - 1476-5527 (Electronic)
IS  - 0950-9240 (Linking)
VI  - 27
IP  - 7
DP  - 2013 Jul
TI  - Persistent elevation of central pulse pressure during postural stress in patients 
      with type 2 diabetes mellitus.
PG  - 437-44
LID - 10.1038/jhh.2012.60 [doi]
AB  - An abnormal increase or decrease in blood pressure (BP) in response to postural 
      stress is associated with increased risk of developing hypertension and stroke. 
      However, the haemodynamic responses contributing to changes in central BP with 
      postural stress are not well characterised. We aimed to determine this in 
      controls compared to patients with type 2 diabetes mellitus (T2DM), whom we 
      hypothesised would have an abnormal postural response. 41 participants (20 
      control, 21 T2DM) underwent measurement of brachial and central BP (by radial 
      tonometry), with simultaneous bioimpedance cardiography (to determine stroke 
      volume (SV) and cardiac output (CO)) and heart rate variability in seated and 
      standing postures. Systemic vascular resistance (SVR; mean arterial pressure/CO), 
      and arterial elastance (EA; end systolic pressure/SV) were calculated. Postural 
      changes were defined as seated minus standing values. Central pulse pressure (PP) 
      was higher in patients with T2DM and did not change from seated-to-standing 
      positions, whereas there was a significant decrease upon standing in controls 
      (P<0.05). The change in central systolic BP (SBP) correlated with change in SVR 
      and EA in controls (r=0.67 and 0.68, P<0.05, respectively), but not in patients 
      with T2DM (r=-0.05 and r=0.03, P>0.05, respectively). SV was the only significant 
      correlate of change in central SBP in T2DM patients (r=0.62, P<0.05) and this was 
      not observed in controls (r=-0.08 P>0.05). We conclude that central haemodynamic 
      responses to postural stress are altered in patients with T2DM and result in 
      persistent elevation of central PP while standing. This may contribute to 
      increased cardiovascular risk associated with T2DM.
FAU - Schultz, M G
AU  - Schultz MG
AD  - Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, 
      Australia.
FAU - Climie, R E D
AU  - Climie RE
FAU - Nikolic, S B
AU  - Nikolic SB
FAU - Ahuja, K D
AU  - Ahuja KD
FAU - Sharman, J E
AU  - Sharman JE
LA  - eng
PT  - Journal Article
DEP - 20121220
PL  - England
TA  - J Hum Hypertens
JT  - Journal of human hypertension
JID - 8811625
SB  - IM
MH  - Aged
MH  - Aorta/physiopathology
MH  - *Blood Pressure
MH  - Blood Pressure Determination/methods
MH  - Brachial Artery/physiopathology
MH  - Cardiac Output
MH  - Cardiography, Impedance
MH  - Case-Control Studies
MH  - Chi-Square Distribution
MH  - Diabetes Mellitus, Type 2/*complications/diagnosis/physiopathology
MH  - Elasticity
MH  - Female
MH  - Humans
MH  - Hypertension/diagnosis/*etiology/physiopathology
MH  - Male
MH  - Manometry
MH  - Middle Aged
MH  - *Posture
MH  - Pulse Wave Analysis
MH  - Vascular Resistance
MH  - Vascular Stiffness
EDAT- 2012/12/21 06:00
MHDA- 2014/01/22 06:00
CRDT- 2012/12/21 06:00
PHST- 2012/12/21 06:00 [entrez]
PHST- 2012/12/21 06:00 [pubmed]
PHST- 2014/01/22 06:00 [medline]
AID - jhh201260 [pii]
AID - 10.1038/jhh.2012.60 [doi]
PST - ppublish
SO  - J Hum Hypertens. 2013 Jul;27(7):437-44. doi: 10.1038/jhh.2012.60. Epub 2012 Dec 
      20.