Autonomic neuropathy is associated with increased cardiovascular risk factors: the EURODIAB IDDM Complications Study

Aims To assess the prevalence of and risk factors for autonomic neuropathy in the EURODIAB IDDM Complications Study. Methods The study involved the examination of randomly selected Type I (insulin‐dependent) diabetic patients from 31 centres in 16 European countries. Neuropathic symptoms and two tests of autonomic function (changes in heart rate and blood pressure from lying to standing) were assessed and data from 3007 patients were available for the present analysis. Autonomic neuropathy was defined as an abnormality of at least one of the tests. Results The prevalence of autonomic neuropathy was 36% with no sex differences. The frequency of one and two abnormal reflex tests was 30% and 6%, respectively. The R–R ratio was abnormal in 24% of patients while 18% had orthostatic hypotension defined as a fall in systolic blood pressure > 20 mmHg on standing. Significant correlations were observed between autonomic neuropathy and age (P