Blood pressure circadian rhythms and adverse outcomes in type 2 diabetes patients diagnosed with orthostatic hypotension

Aims/Introduction Patients with diabetes frequently develop orthostatic hypotension (OH). The present study was designed to examine the relationship of blood pressure (BP) circadian rhythms and outcomes in diabetes with OH. Materials and Methods In this study, 173 inpatients with type 2 diabetes were enrolled. Subjects were divided into an OH group and a non-OH group according to the BP changes detected in supine and standing position. 24-h ambulatory blood pressure was monitored. Then, subjects were followed up for an average of 45 ± 10 months post-discharge. Outcomes - death and major adverse cardiac and cerebrovascular events, including heart failure, myocardial infarction, and stroke - were recorded. Results There were 61 subjects (35.26%) in the OH group and 112 subjects (64.74%) in the non-OH group. In the OH group, the nighttime systolic BP and nighttime diastolic BP were higher, the blood pressure circadian rhythms were predominantly of the riser type (67.21%). OH was as an independent marker of riser type circadian rhythm (adjusted OR 4.532; 95% CI 2.579–7.966). In the OH group, the incidence rates of mortality and major adverse cardiac and cerebrovascular events were increased significantly compared to those in the non-OH group (11.48% vs 2.68%, P = 0.014; 37.70% vs 8.93%, P < 0.01). Conclusions In subjects who had type 2 diabetics diagnosed with OH, the BP circadian rhythm usually showed riser patterns, and they had increased rates of mortality and major adverse cardiac and cerebrovascular events. This article is protected by copyright. All rights reserved.