Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Original article / research
Year : 2017 | Month : April | Volume : 11 | Issue : 4 | Page : OC09 - OC13

Prevalence of Autonomic Neuropathy in Patients of Rheumatoid Arthritis and Its Correlation with Disease Severity

Devika Aggarwal, Sumeet Singla

1. Intern, Maulana Azad Medical College, New Delhi, India. 2. Associate Professor, Department of Medicine, Maulana Azad Medical College, New Delhi, India.

Correspondence Address :
Dr. Devika Aggarwal,
C-51, Sec-19, Noida-201301, Uttar Pradesh, India.


Introduction: Autonomic Neuropathy (AN), found to be a strong predictor of sudden cardiac death, has been reported variably in patients with Rheumatoid Arthritis (RA). Manifesting as sweating disturbances, gastrointestinal irregularities, bladder or erectile dysfunction, AN can significantly affect a patient’s quality of life and alter the course of the disease.

Aim: This study was undertaken to find out the prevalence and severity of AN in RA patients attending the Rheumatology Clinic at a Tertiary Care Hospital in New Delhi, India and also to investigate its correlation with patient and disease factors such as age, gender, disease severity, duration and serological status.

Materials and Methods: In this cross-sectional study, AN was assessed subjectively by a survey of autonomic symptoms. Cardiac autonomic involvement was assessed by five cardiovascular reflex tests as described by Ewing: Heart Rate (HR) response to deep breathing, standing, and Valsalva and Blood Pressure (BP) response to standing and sustained handgrip.

Results: A total of 31 RA patients and 31 age and sex matched healthy volunteers were recruited. Upon analysis it was found that the prevalence of cardiac AN was significantly higher in patients (80.65%) as compared to controls (51.61%) (p=0.016). Positive correlation with disease severity was observed with the patient reported questionnaire but not with the objective cardiovascular reflex tests. No significant correlation between grade of AN and patient’s age, gender, disease duration or serological status was established.

Conclusion: At the end of the study, it was concluded that the pathological mechanisms responsible for autonomic dysfunction are more active in RA as compared to others.


Autonomic dysfunction, Chronic inflammatory disorder, Extra-articular manifestations

How to cite this article :

Devika Aggarwal, Sumeet Singla. PREVALENCE OF AUTONOMIC NEUROPATHY IN PATIENTS OF RHEUMATOID ARTHRITIS AND ITS CORRELATION WITH DISEASE SEVERITY. Journal of Clinical and Diagnostic Research [serial online] 2017 April [cited: 2017 May 24 ]; 11:OC09-OC13. Available from

DOI and Others

DOI: 10.7860/JCDR/2017/24182.9614

Date of Submission: Sep 14, 2016
Date of Peer Review: Jan 12, 2017
Date of Acceptance: Jan 18, 2017
Date of Publishing: Apr 01, 2017


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