Nine insulin-dependent diabetic (IDDM) patients (aged 25–37 yr) with no symptoms of autonomic neuropathy and 15 healthy control subjects (aged 26–39 yr) were studied at rest and during tests of Valsalva maneuver, deep breathing, cold pressor, and postural change from sitting to standing. Continuous (beat-to-beat) measures were taken of heart rate, systolic blood pressure, diastolic blood pressure, and skin conductance. The diabetic patients were differentiated from the control group by the following: less variability in diastolic blood pressure during deep breathing, failure to exhibit diastolic blood pressure decreases during recovery from a cold pressor stimulus, a flatter blood pressure response pattern when changing from sitting to standing, and a smaller standing ratio (maximum/minimum) for R-R interval. Among the patients, age was negatively correlated with systolic and diastolic standing ratios and diastolic blood pressure variability during deep breathing. By use of the tracking cuff, a method of continuously recording blood pressure noninvasively, we have been able to assess subtle blood pressure changes, thereby revealing signs of sympathetic dysfunction in a group of relatively young diabetic patients with no symptoms of neuropathy. The tracking-cuff method of recording blood pressure has potential in further research on autonomic functioning in diabetic patients.
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Original Articles|
November 01 1988
Beat-to-Beat Blood Pressure Response in Asymptomatic IDDM Subjects
Iris B Goldstein, PhD;
Iris B Goldstein, PhD
Departments of Psychiatry and Biobehavioral Sciences and of Anesthesiology, University of California
Los Angeles
; Behavioral Medicine Research, Sepulveda V. A. Medical Center
Sepulveda
; and the Department of Medicine, Long Beach V. A. Medical Center/University of California
Irvine, California
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Bruce D Naliboff, PhD;
Bruce D Naliboff, PhD
Departments of Psychiatry and Biobehavioral Sciences and of Anesthesiology, University of California
Los Angeles
; Behavioral Medicine Research, Sepulveda V. A. Medical Center
Sepulveda
; and the Department of Medicine, Long Beach V. A. Medical Center/University of California
Irvine, California
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David Shapiro, PhD;
David Shapiro, PhD
Departments of Psychiatry and Biobehavioral Sciences and of Anesthesiology, University of California
Los Angeles
; Behavioral Medicine Research, Sepulveda V. A. Medical Center
Sepulveda
; and the Department of Medicine, Long Beach V. A. Medical Center/University of California
Irvine, California
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Harrison JL Frank, MD, PhD
Harrison JL Frank, MD, PhD
Departments of Psychiatry and Biobehavioral Sciences and of Anesthesiology, University of California
Los Angeles
; Behavioral Medicine Research, Sepulveda V. A. Medical Center
Sepulveda
; and the Department of Medicine, Long Beach V. A. Medical Center/University of California
Irvine, California
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Address correspondence and reprint requests to Dr. David Shapiro, Department of Psychiatry, UCLA, 760 Westwood Plaza, Los Angeles, CA 90024-1759.
Citation
Iris B Goldstein, Bruce D Naliboff, David Shapiro, Harrison JL Frank; Beat-to-Beat Blood Pressure Response in Asymptomatic IDDM Subjects. Diabetes Care 1 November 1988; 11 (10): 774–779. https://doi.org/10.2337/diacare.11.10.774
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