Orthostatic hypotension (OH) affects one quarter of type 2 diabetes mellitus (T2D) subjects. From the pathophysiological perspective, OH is potentiated by cardiovascular autonomic neuropathy (CAN), endothelial dysfunction and generation of advanced glycation end products (AGE), all features involved in the progression of atherosclerosis. In this context, OH has emerged as a compelling surrogate marker for the detection of patients at a greater risk of cardiovascular outcomes. This hypothesis has yet not been confirmed. To test this hypothesis, this project was designed as a predefined, observational, cross-sectional analysis of the Brazilian Diabetes Study (BDS) Database, a prospective ongoing cohort held in Brazil, which since 2016 has enrolled 1040 individuals with T2D, older than 18 years. All participants underwent blood pressure (BP) measurements sitting and standing with an interval of 1 minute; carotid Doppler ultrasonography, coronary calcium score and AGE Reader measurement using an Skin autofluorescence device. The primary goal is to assess the relationship between orthostatic blood pressure variation and atherosclerotic cardiovascular disease. Secondary goals include determining clinical phenotypes of patients with T2D more prone to developing OH.
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