Postural Hypotension in Male Diabetics With Autonomic Cardiovascular Dysfunction and Impotence

Abstract

Objective: To find out frequency of postural hypotension in male diabetics with autonomic
cardiovascular dysfunction and impotence.
Material & Methods: A total of 200 male 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.