Author : Rohini N S, Bhanupriya, Anusuya S K, Ravishankar S N, Akshay S Atre, Pooja Shettannavar, Rakshith N R
Abstract : Introduction: Cardiovascular diseases (CVDs) are one of the leading causes of death in women across
the globe. CVD is more prevalent in women after menopause due to the lack of estrogens which have
a cardioprotective effect Menopause and diabetes mellitus are individually high risk for cardiovascular
autonomic neuropathy which in turn results in CV accidents and deaths.
Aims and Objectives: The aim of this study was to evaluate the Autonomic Nervous System dysfunctions
in post menopausal women with diabetes mellitus, to grade the severity of dysfunctions and to compare the
severity of the ANS dysfunction with age matched healthy controls.
Materials and Methods: This observational study was conducted in the department of Obstetrics and
Gynecology, Akash Institute of Medical Sciences & Research Centre, Devanahalli, Bengaluru, Karnataka,
India. A total of 120 postmenopausal women were examined for the study. They were divided into two
equal groups (60 women in each group) as menopausal women with diabetes and without diabetes. The
ANS dysfunctions were evaluated based on symptoms and also specific tests like heart rate response to
Valsalva maneuver, heart rate response to standing up from supine position, blood pressure response to
sustained handgrip, blood pressure response to standing up from supine position. The ANS dysfunctions
were categorized into mild, moderate and severe dysfunctions.
Results: Of the 60 postmenopausal women without diabetes, 20 women had symptoms of autonomic
dysfunction in the form of hot flushes, giddiness and palpitations, (33%) and they also tested positive for
ANS dysfunction. Though the remaining 40 women did not have any symptoms, they tested positive for
ANS dysfunction. 40 women had mild ANS dysfunctions, 12 had moderate dysfunctions and 8 had severe
dysfunctions. In the other group of postmenopausal women with diabetes, 30 women had symptoms of ANS
dysfunction (50%) and also tested positive for ANS dysfunction. The remaining 30 women, though did not
have any symptoms, they also tested positive for ANS dysfunctions. 30 of them had mild dysfunctions, 18
had moderate dysfunctions and 12 had severe dysfunctions.
Conclusion: Our study has broadly shown that postmenopausal women suffer from autonomic
derangements, and degree and severity of such derangements are much higher in post menopausal women
with diabetes mellitus and are possibly at an increased risk of developing heart disease. Hence early
detection, good control of diabetes and early detection of autonomic dysfunction and management is
important in these women.
Keywords: Post-menopausal women, Diabetes, Autonomic function tests, Cardiovascular disease.