May 13, 1999

Hypovolemia contributes to the pathogenesis of orthostatic hypotension in patients with diabetes mellitus

The American Journal of Medicine
K Laederach-HofmannP Ferrari

Abstract

To investigate whether body sodium content and blood volume contribute to the pathogenesis of orthostatic hypotension in patients with diabetes mellitus. Exchangeable sodium, plasma and blood volumes, and catecholamine, renin, and aldosterone levels were assessed in 10 patients with Type II diabetes mellitus who had orthostatic hypotension and control groups of 40 diabetic patients without orthostatic hypotension and 40 normal subjects of similar age and sex. In subgroups, clinical tests of autonomic function and cardiovascular reactivity to norepinephrine and angiotensin II infusions were performed. In diabetic patients with orthostatic hypotension, mean (+/- SD) supine blood pressure was 165/98 +/- 27/12 mm Hg (P <0.05 compared with other groups) and mean upright blood pressure was 90/60 +/- 38/18 mm Hg. Compared with controls, diabetic patients with orthostatic hypotension had a 10% lower blood volume. They also had less exchangeable sodium than patients with diabetes who did not have orthostatic hypotension (P <0.01). Compared with both groups of controls, diabetic patients with orthostatic hypotension had decreased 24-hour urinary norepinephrine excretion and a reduced diastolic blood pressure response to handgrip (P <0.05...Continue Reading

  • References26
  • Citations6

References

  • References26
  • Citations6

Citations

Mentioned in this Paper

Diabetes Mellitus, Non-Insulin-Dependent
Pathogenic Aspects
Diastolic Blood Pressure Measurement
Creatinine
Aldosterone Measurement
Hypernatremia
Pathogenesis
Aldosterone, (+-)-Isomer
Filtration
Body Parts - Cannula

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