Association of Cardiovascular Autonomic Dysfunction with Peripheral Arterial Stiffness in Patients with Type 1 Diabetes

Abstract

Cardiovascular autonomic neuropathy (CAN) appears to contribute to peripheral arterial stiffness (AS) in type 1 diabetes. Whether CAN in patients with AS is associated with concomitant asymptomatic peripheral arterial disease (aPAD) remains unclear. Objective: To assess the risk of CAN in patients with type 1 diabetes and AS and its potential association with atherosclerosis. Design: Cross-sectional study. Setting: Type 1 diabetes clinic in an academic hospital. Patients: Two hundred sixty-four patients with type 1 diabetes. Intervention: AS was defined as an ankle-brachial index (ABI) .1.2, aPAD by the toe-brachial index and Doppler sonography, and CAN by blood pressure and heart rate responses to active standing and Ewing and Clarke tests. Main Outcome Measures: Odds of having CAN among patients with AS. Odds for CAN were also calculated as a function of the presence of AS and concomitant aPAD.