The objective of this study was to test the relationship between neurologic and microvascular complications of @entity6 . It was hypothesized that the mechanisms operative in @entity5433 seen in @entity6 @entity1 with @entity455 play a role in the rapidity of progression to @entity177 . Twenty-six type 1 @entity6 @entity1 with @entity644 were studied with computerized monitoring of heart rate variation during timed ventilation, assumption of upright posture, and Valsalva maneuver and with 24-h ambulatory blood pressure monitoring at baseline. Renal function was evaluated over the ensuing 12 months of intensive insulin therapy. Blood pressure was treated so as to achieve consistent 24-h readings < 140/90 mm Hg. Angiotensin converting enzyme inhibitors were the preferred antihypertensive agents. Serial serum @entity1011 concentrations were compared using repeated measures analysis of variance. Over 12 months there were no significant serum @entity1011 changes for any autonomic test group with normal results at baseline. Groups with abnormal autonomic results at baseline demonstrated statistically significant increases in serum @entity1011 over 12 months compared to their baseline. Of the tests, Valsalva separated groups of @entity1 with similar degrees of baseline @entity8 . Each of the sympathetic plus Valsalva combinations demonstrated a significant difference in progression of serum @entity1011 increase over 12 months. In each instance, if both sympathetic and Valsalva results were abnormal, there was a statistically significant increase in serum @entity1011 over 12 months when compared to groups in which one or both test results were normal. There is a relationship between autonomic function and the progression of @entity8 . The inability to vary the heart rate to a Valsalva maneuver identifies a degree of @entity409 that permits unopposed sympathetic tone, heralding more rapid renal destruction. A simple inexpensive bedside laboratory test discerned a relatively low-risk group of @entity6 @entity1 with @entity644 that demonstrated no deterioration in renal function over 12 months. When the Valsalva maneuver was markedly abnormal the presence of a mean arterial pressure > 100 mm Hg was associated with a greater likelihood of rapid @entity177 . This group at higher risk of @entity177 should undergo aggressive lowering of mean arterial blood pressure to < 95 mm Hg.

Relationship between autonomic function and progression of XXXX in @entity6 : clinical correlations and implications for blood pressure control.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity644 :: ('MESH:D011507', 'Disease') :: ['proteinuria'] @entity8 :: ('MESH:D007674', 'Disease') :: ['renal impairment', 'renal dysfunction'] @entity455 :: ('MESH:D014652', 'Disease') :: ['microangiopathy'] @entity6 :: ('MESH:D003920', 'Disease') :: ['type 1 diabetes mellitus', 'diabetic'] @entity409 :: ('MESH:D008107', 'Disease') :: ['parasympathetic dysfunction'] @entity177 :: ('MESH:D051437', 'Disease') :: ['renal deterioration', 'renal failure'] @entity1011 :: ('MESH:D003404', 'Chemical') :: ['creatinine'] @entity5433 :: ('MESH:C563939', 'Disease') :: ['autonomic dysfunction']
@entity8 :: (MESH:D007674,Disease) :: ['renal disease']
