Cardiovascular autonomic neuropathy (CAN) is a frequent complication of diabetes mellitus and is associated with increased morbidity and mortality in patients with diabetes. Hence, early and correct diagnosis of CAN is crucial. Standard cardiovascular reflex rests (CARTs) have been the gold standard of CAN assessment. Originally, CARTs consisted of five reflex tests, but measuring diastolic blood pressure response to sustained handgrip exercise has no longer been suggested as an established clinical test.

Increasing body of evidence suggests that isometric handgrip test should no longer be used for the evaluation of sympathetic dysfunction during cardiovascular autonomic neuropathy assessment in diabetic patients. The associations of isometric handgrip test results with parameters of hypertension and markers of hypertension-related target-organ damage in diabetic and non-diabetic individuals point toward its potential role as a screening tool to identify patients with high cardiovascular risk. The current review summarizes historical view of standard cardiovascular reflex tests and latest data on isometric handgrip test.

心血管自主神经病变（CAN）是糖尿病的常见并发症，与糖尿病患者发病率和死亡率增加相关。因此，早期、正确诊断 CAN 至关重要。标准心血管反射休息 (CART) 一直是 CAN 评估的黄金标准。最初，CART 由五项反射测试组成，但测量舒张压对持续握力运动的反应已不再被建议作为一项既定的临床测试。

越来越多的证据表明，等长握力试验不应再用于评估糖尿病患者心血管自主神经病变期间的交感功能障碍。等长握力测试结果与糖尿病和非糖尿病个体的高血压参数和高血压相关靶器官损伤标志物的关联表明其作为筛查工具的潜在作用，以识别具有高心血管风险的患者。当前的评论总结了标准心血管反射测试的历史观点和等长握力测试的最新数据。