Autonomic neuropathy, arterial hypertension and diabetes mellitus
Calle Pascual, A.L.; Romero Ganuza, J.; Gómez Recio, M.; Martín Alvarez, P.
Medicina Clinica 84(11): 437-439
1985
ISSN/ISBN: 0025-7753 PMID: 3990406 Document Number: 249845
The incidence of autonomic neuropathy at the cardiovascular level (multitest) was studied among 20 diabetic patients with arterial hypertension and without clinical nephropathy (13 patients with systolic and diastolic hypertension and 7 patients with systolic hypertension only). Clinical absence of diabetic nephropathy was defined as having a creatinine clearance of > 60 ml/min, without proteinuria and with a serum creatinine of < 1.1 mg/dl. The results were compared to 81 diabetic normotensive patients. The incidence of .gtoreq. 1 pathological parasympathetic cardiovascular test was higher in diabetic patients with systolic and diastolic hypertension (61.53%; P < 0.01) than in diabetic patients with systolic hypertension only (42.85%; n.s.), and than in normotensive diabetics (38.27%). The incidence of sympathetic neuropathy was also higher in diabetic patients with systolic and diastolic hypertension (53.84%; P < 0.01) than in normotensive patients (24.68%); sympathetic neuropathy was not found among patients with systolic hypertension only. The presence of autonomic neuropathy in hypertensive patients correlates with the time of evolution of the diabetes (P < 0.001) and with the retinal (P < 0.005) and peripheral neurologic complications (P < 0.006). Autonomic neuropathy can play a role in the pathogenesis of the systolic and diastolic hypertension of diabetic patients without clinical diabetic nephropathy. It is likely though, that these are 2 events that are found concurrently in the course of diabetes mellitus.