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The relationship of heart rate and heart rate variability to non‐diabetic fasting glucose levels and the metabolic syndrome: The Cardiovascular Health Study
Author(s) -
Stein P. K.,
Barzilay J. I.,
Domitrovich P. P.,
Chaves P. M.,
Gottdiener J. S.,
Heckbert S. R.,
Kronmal R. A.
Publication year - 2007
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2007.02163.x
Subject(s) - medicine , impaired fasting glucose , heart rate variability , metabolic syndrome , endocrinology , diabetes mellitus , impaired glucose tolerance , heart rate , type 2 diabetes , blood pressure
Background Increased heart rate (HR) and diminished heart rate variability (HRV) are signs of early cardiovascular autonomic neuropathy. We tested the hypotheses that increased HR and diminished HRV are present in people: (i) with increased fasting glucose (FG) levels not in the range of diabetes mellitus (DM), and (ii) in people with the metabolic syndrome (MetS) independent of elevated FG levels. Methods HR and HRV were determined in 1267 adults (mean age 72 years) who had Holter monitoring and FG measures: 536 had normal FG levels (NORM, FG 4.5–5.5 mmol/l), 363 had mildly impaired FG (IFG‐1, FG 5.6–6.0 mmol/l), 182 had significantly impaired FG (IFG‐2, FG 6.1–6.9 mmol/l) and 178 had DM (FG > 6.9 mmol/l or use of glucose‐lowering agents/insulin). HR and HRV in NORM/IFG‐1 was further compared by the number of components of the MetS and compared by the presence or absence of MetS in IFG‐2/DM. Results HRV indices were more impaired in IFG‐2 and DM than in NORM or IFG‐1. There were few differences in HRV indices between NORM and IFG‐1 or between IFG‐2 and DM. In NORM/IFG‐1 participants, having ≥ 2 components of the MetS was associated with a greater decrease in HRV compared with having no or one components. In IFG‐2/DM participants, MetS was associated with decreased HRV compared with no MetS. Conclusions Increased HR and diminished HRV occur in the non‐diabetic FG range. Diminished HRV is associated with the MetS, independent of FG levels. Both these results suggest that factors associated with increasing non‐diabetic FG levels and the MetS play a role in the onset of cardiac autonomic impairment.