Sajid Nisar, Tahir Bashir, Faisal Masud.
Postural Hypotension in Male Diabetics With Autonomic Cardiovascular Dysfunction and Impotence.
Esculapio J Services Inst Med Sci Jan ;8(1):1-4.

Objective: To find out frequency of postural hypotension in male diabetics with autonomic cardiovascular dysfunction and impotence. Material & Methods: A total of 200 diabetic patients, attending Diabetes Management Centre Services Hospital Lahore, were enrolled in the study. All the diabetic patients between ages 14-60 years, having fasting blood sugar level more than 126 mg/dl, were included. Adetailed history was taken and all patients underwent relevant physical examination blood pressure was taken in supine and standing position and investigations like random blood sugar levels were checked. The diagnosis of autonomic cardiovascular dysfunction was documented by heart rate response to valsalva maneuver. The ratio of longest R-R to shortest R-R is < 1.2 during valsalva in patients with autonomic cardiovascular dysfunction. The postural hypotension in diabetic patients was calculated after recording the postural drop in all the patients. Before assessing blood pressure variation with postural change 20 min supine rest was mandatory. Results: The age range was from 14-60 years. The percentage of patients with postural drop was 32 percent in the presence of parasympathetic dysfunction. The mean age of patients with parasympathetic dysfunction was 50.65±5.53 years. Conclusion: Postural hypotension does not seem to be a good marker for autonomic neuropathy. The proportion of patients having postural hypotension in the presence of parasympathetic dysfunction was not significant in the study population. However significant correlation of postural hypotension with duration of diabetes was found.

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