{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T16:33:50Z","timestamp":1762101230564},"reference-count":25,"publisher":"American Diabetes Association","issue":"11","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2011,11,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>We have recently demonstrated that early autonomic dysfunction, defined as low baroreflex sensitivity (BRS), could be functional and reversible. However, potential temporal changes in BRS have not yet been addressed by longitudinal studies in type 1 diabetes. Moreover, it is not known whether low BRS predisposes to hypertension or other nonfatal diabetes complications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>We conducted a 5-year prospective study including 80 patients with type 1 diabetes. We measured ambulatory blood pressure and autonomic function tests. BRS was assessed by six different methods during spontaneous, controlled, and slow deep breathing at baseline and follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Spontaneous BRS declined over time (BRSaverage 16.2 \u00b1 0.8 vs. 13.2 \u00b1 0.8 ms\/mmHg; P &amp;lt; 0.01), but the change was not significant when adjusted for time of follow-up. Low BRS at baseline did not progress to cardiac autonomic neuropathy but predicted an increase in the nighttime systolic blood pressure (BRSaverage\u2008r = \u22120.37; P &amp;lt; 0.05). Additionally, BRS response to deep breathing at baseline predicted an increase in 24-h ambulatory blood pressure (BRS-\u03b1LF r = 0.323\u20130.346; P &amp;lt; 0.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>The decline in spontaneous BRS over time in patients with type 1 diabetes seems to be due to normal aging, which supports a functional etiology behind early autonomic derangements. Decreased resting BRS and the magnitude of improvement by deep breathing may be due to sympathovagal imbalance, a well-known mechanism in the development of hypertension. Early interventions aiming to reduce sympathetic overactivity in patients with low BRS might delay the development of hypertension.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc11-0629","type":"journal-article","created":{"date-parts":[[2011,9,28]],"date-time":"2011-09-28T05:20:21Z","timestamp":1317187221000},"page":"2424-2430","update-policy":"http:\/\/dx.doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":15,"title":["Baroreflex Sensitivity and Its Response to Deep Breathing Predict Increase in Blood Pressure in Type 1 Diabetes in a 5-Year Follow-Up"],"prefix":"10.2337","volume":"34","author":[{"given":"Milla","family":"Roseng\u00e5rd-B\u00e4rlund","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland"},{"name":"Folkh\u00e4lsan Institute of Genetics, Folkh\u00e4lsan Research Center, University of Helsinki, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luciano","family":"Bernardi","sequence":"additional","affiliation":[{"name":"Folkh\u00e4lsan Institute of Genetics, Folkh\u00e4lsan Research Center, University of Helsinki, Helsinki, Finland"},{"name":"Department of Internal Medicine, University of Pavia, and Istituto di Ricovero e Cura a Carattere Scientifico S. Matteo, Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Sandelin","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland"},{"name":"Folkh\u00e4lsan Institute of Genetics, Folkh\u00e4lsan Research Center, University of Helsinki, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol","family":"Forsblom","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland"},{"name":"Folkh\u00e4lsan Institute of Genetics, Folkh\u00e4lsan Research Center, University of Helsinki, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Per-Henrik","family":"Groop","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland"},{"name":"Folkh\u00e4lsan Institute of Genetics, Folkh\u00e4lsan Research Center, University of Helsinki, Helsinki, Finland"},{"name":"Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the FinnDiane Study Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1167","published-online":{"date-parts":[[2011,10,15]]},"reference":[{"key":"2022031220200011600_B1","doi-asserted-by":"crossref","first-page":"334","DOI":"10.2337\/diacare.29.02.06.dc05-1242","article-title":"Cardiac autonomic neuropathy predicts cardiovascular morbidity and mortality in type 1 diabetic patients with diabetic nephropathy","volume":"29","author":"Astrup","year":"2006","journal-title":"Diabetes Care"},{"key":"2022031220200011600_B2","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.2337\/diacare.26.6.1895","article-title":"The association between cardiovascular autonomic neuropathy and mortality in individuals with diabetes: a meta-analysis","volume":"26","author":"Maser","year":"2003","journal-title":"Diabetes Care"},{"key":"2022031220200011600_B3","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1007\/s00125-009-1340-9","article-title":"Early autonomic dysfunction in type 1 diabetes: a reversible disorder?","volume":"52","author":"Roseng\u00e5rd-B\u00e4rlund","year":"2009","journal-title":"Diabetologia"},{"key":"2022031220200011600_B4","doi-asserted-by":"crossref","first-page":"1862","DOI":"10.1007\/s00125-011-2164-y","article-title":"Deep breathing improves blunted baroreflex sensitivity even after 30 years of type 1 diabetes","volume":"54","author":"Roseng\u00e5rd-B\u00e4rlund","year":"2011","journal-title":"Diabetologia"},{"key":"2022031220200011600_B5","doi-asserted-by":"crossref","first-page":"1718","DOI":"10.2337\/dc10-0030","article-title":"Survival of patients with type 1 diabetes receiving renal replacement therapy in 1980-2007","volume":"33","author":"Haapio","year":"2010","journal-title":"Diabetes Care"},{"key":"2022031220200011600_B6","doi-asserted-by":"crossref","first-page":"1853","DOI":"10.2337\/db09-1904","article-title":"Are individuals with diabetes seeing better? 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