Low blood pressure and diabetic complications

This study examined whether orthostatic hypotension is associated with the prevalence of diabetic complications and mortality. The authors concluded that orthostatic hypotension is associated with a higher prevalence of diabetic complications and a higher mortality rate.

High blood glucose levels can lead to complications such as damage to the small and large blood vessels. This can increase the risk of heart attack or stroke. Other diabetic complications include damage to the nerves, eyes and kidneys. Diabetic patients who have damaged nerves may experience orthostatic hypotension (OH). OH is low blood pressure that occurs when a person stands from sitting or lying down. It is believed that OH may be associated with a higher prevalence of diabetic complications and a higher mortality rate. 

Peripheral artery disease (PAD) is the narrowing of arteries which results in reduced blood flow to the limbs. PAD is an indicator of a potential heart attack or stroke.

This study aimed to determine whether the prevalence of diabetic complications and the mortality rate is higher in patients with OH. This study involved 60 patients with type 1 diabetes (T1D) and 127 patients with type 2 diabetes (T2D). Participants were divided into two groups based on the presence or absence of OH. The prevalence of diabetic complications and the mortality rate was assessed over a 10 year period in participants.

31.7% of T1D patients had OH. T1D patients were 10.67 times more likely to have a heart attack if they had OH. T1D patients with OH were 14.18 times more likely to have peripheral artery disease (PAD, reduced blood flow to the limbs due to narrowed arteries). T1D patients with OH were 8.68 times more likely to experience kidney damage, and 8 times more likely to experience eye damage. Patients wiht T1D and OH were 17.1 times more likely to develop damage to the nerves of the arms or legs.

32.3% of T2D patients had OH. T2D patients were 3.33 times more likely to have a stroke if they had OH. T2D patients with OH were 3.26 times more likely to have PAD. T2D patients were 3.24 times more likely to experience kidney damage and 4.08 times more likely to develop eye disease if they had OH. Patients with T2D and OH were 7.51 times more likely to develop damage to the nerves of the arms or legs.

The mortality rate was higher in patients who had OH.

This study concluded that orthostatic hypotension is associated with a higher prevalence of diabetic complications and a higher mortality rate.

There was a low number of T1D patients who experienced a stroke. This may have been the reason why there was no association observed between OH and stroke in T1D patients.