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Cardiac autonomic function and insulin resistance for the development of hypertension: a six-year epidemiological

J S Wu1, Y C Yang, F H Lu

  • 1Department of Family Medicine, College of Medicine, National Cheng Kung University, Taiwan, ROC; Department of Family Medicine, National Cheng Kung University Hospital, Taiwan, ROC.

Nutrition, Metabolism, and Cardiovascular Diseases : NMCD
|February 20, 2013
PubMed

Insights

Cardiac autonomic function, specifically sympathovagal imbalance with reduced parasympathetic tone, predicts new-onset hypertension. Insulin resistance did not independently predict hypertension when autonomic function was considered.

Area of Science:

  • Cardiology
  • Autonomic Nervous System Research
  • Metabolic Syndrome Studies

Background:

  • Cardiac autonomic function (CAF) and insulin resistance (IR) are implicated in cardiovascular health.
  • Understanding their independent and combined roles in hypertension development is crucial.

Purpose of the Study:

  • To investigate the impact of cardiac autonomic function and insulin resistance on the incidence of hypertension.
  • To determine if autonomic dysfunction or insulin resistance is a stronger predictor of new-onset hypertension.

Main Methods:

  • Longitudinal study involving 1638 participants at baseline (1996) and 959 at follow-up (2003).
  • Assessment of cardiac autonomic function using heart rate variability (SDNN, LF, HF, LF/HF ratio, E/I ratio) and time-domain measures.
  • Evaluation of insulin resistance using homeostasis model assessment (HOMA-IR and HOMA-B).

Main Results:

  • In multivariate analysis, insulin resistance (square root of HOMA-IR) was associated with incident hypertension.
  • This association disappeared after adjusting for baseline cardiac autonomic function.
  • Specific measures of sympathovagal imbalance, including LF/HF ratio, HF power, and E/I ratio, were independently associated with incident hypertension.

Conclusions:

  • Sympathovagal imbalance, characterized by decreased parasympathetic tone, is a significant independent predictor of incident hypertension.
  • Cardiac autonomic dysfunction, rather than insulin resistance, appears to be a more critical factor in the development of hypertension in this cohort.
Abstract

Keywords:
30max/15min ratioCAFCardiac autonomic functionE/I ratioHFHOMA-BHOMA-IRIRIncident hypertensionInsulin resistanceLFSDNNa ratio between the RR intervals during expiration and inspirationa ratio between the longest RR interval around the 30th beat and the shortest RR interval around the 15th beat after standingcardiac autonomic functionhigh frequencyhomeostasis model assessment for insulin resistancehomeostasis model assessment to define beta cell functioninsulin resistancelow frequencystandard deviation of normal-to-normal intervals or RR intervals

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