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Diabetes Care, Vol 8, Issue 5 491-498, Copyright © 1985 by American Diabetes Association
The value of cardiovascular autonomic function tests: 10 years experience in diabetes
DJ Ewing, CN Martyn, RJ Young and BF Clarke
Five simple, noninvasive cardiovascular reflex tests have been used to
assess autonomic function in one center over the past 10 yr. Seven hundred
seventy-four diabetic subjects were tested for diagnostic and research
purposes. In 543 subjects completing all five tests, abnormalities of heart
rate tests occurred in 40%, while abnormal blood pressure tests occurred in
less than 20%. Their results were grouped as normal (39%), early (15%),
definite (18%), and severe (22%) involvement. Six percent had an atypical
pattern of results. Two hundred thirty-seven diabetic subjects had the
tests repeated greater than or equal to 3 mo apart: 26% worsened, 71% were
unchanged, and only 3% improved. The worsening followed a sequential
pattern with first heart rate and later additional blood pressure
abnormalities. Comparison between a single test (heart rate response to
deep breathing) and the full battery in 360 subjects showed that one test
alone does not distinguish the degree or severity of autonomic damage.
These tests provide a useful framework to assess autonomic neuropathy
simply, quickly, and noninvasively.

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