Characterization of blood pressure and daily stress in Mexican children with Diabetes Mellitus Type 2 risk factors

not been elucidated. Aim: To determine if hemodynamic changes during the Valsalva maneuver promote cerebral hypoperfusion as the etiology of syncope and quantify severity with autonomic failure metrics in a case-control trial. Methods: Hemodynamic changes of nine PAH patients were prospectively obtained and compared with 15 age and gender matched healthy controls. Common Valsalva parameters including adrenergic baroreflex sensitivity, pressure recovery time, systolic blood pressure recovery, diastolic blood pressure recovery, mean arterial pressure recovery, and the Valsalva ratio were calculated. Mann-Whitney U-tests were used to compare continuous variables. The primary end point was adrenergic baroreflex sensitivity. Results: PAH patients had lower adrenergic baroreflex sensitivity (9.7 ± 4.6 vs 18.8 ± 9.2 mmHg/second, P = 0.005), longer pressure recovery time (3.6 ± 2.5 vs 1.7 ± 0.8 seconds, P = 0.008), similar SBP recovery (-13 ± 11vs -12 ± 23 mmHg, P = 0.640), less diastolic blood pressure recovery (13 ± 14 vs -1 ± 12 mmHg, P = 0.025), less mean arterial pressure recovery (-5 ± 11 vs 5 ± 17 mmhg, P = 0.048), and a decreased Valsalva ratio (1.25 ± 0.11 vs 1.60 ± 0.22, P b 0.001) compared to healthy controls. Conclusions: All of the significantly different parameters suggest that primary arterial hypertension patients are more susceptible to cerebral hypoperfusion. PAH patients exhibit a susceptibility to syncope similar to a spectrum of patients with intermediate autonomic failure, who typically experience a systolic blood pressure drop of 10-30 mmHg with standing. Grants: NIH P01 HL 108800, NIH K23 HL 098743