Orthostatic hypotension (OH) is associated with adverse cardiovascular outcomes and may reflect underlying autonomic and vascular dysfunction in patients with diabetes mellitus (DM). A cross-sectional study published in Acta Diabetologica evaluated factors associated with OH and assessed the relationship between arterial stiffness parameters and OH in patients with DM.

The single-center study included 193 patients with DM. Orthostatic blood pressure measurements were obtained in the supine position and again 3 minutes after standing. Arterial stiffness was assessed using oscillometric pulse wave velocity and related vascular parameters measured with a validated oscillometric device. Clinical characteristics, laboratory findings, and medication use were also analyzed.

Findings

• OH was present in 56 patients, representing 29% of the study population.
• Patients with OH had significantly higher central blood pressure and arterial stiffness parameters, including pulse wave velocity, augmentation pressure, and augmentation index.
• Multivariate analysis showed that female sex, older age, diabetic neuropathy, and pulse wave velocity were independently associated with OH.
• Pulse wave velocity remained significantly associated with OH after adjustment for potential confounding factors.
• No significant differences were observed between patients with and without OH regarding antihypertensive medication classes.

The analysis showed that OH in patients with DM was independently associated with increased arterial stiffness and diabetic neuropathy. These findings suggest a relationship between orthostatic blood pressure dysregulation and adverse vascular characteristics, although prospective studies are needed to clarify temporal and clinical implications.