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Heart rate variability is severely impaired among type 2 diabetic patients with hypertension

Ildikó Istenes, Anna Erzsébet Körei, Zsuzsanna Putz

    Diabetes/Metabolism Research and Reviews
    |May 16, 2014
    PubMed

    Insights

    Diabetes significantly impacts heart rate variability more than hypertension. Patients with both conditions face the highest risk of reduced autonomic function, necessitating early assessment.

    Area of Science:

    • Cardiology
    • Endocrinology
    • Autonomic Neuroscience

    Background:

    • Heart rate variability (HRV) is a key indicator of autonomic nervous system function.
    • Both diabetes and hypertension are prevalent conditions known to affect cardiovascular health.
    • The distinct and combined effects of diabetes and hypertension on HRV require further elucidation.

    Purpose of the Study:

    • To comparatively assess the influence of type 2 diabetes and essential hypertension on heart rate variability.
    • To determine the additive or interactive effects of co-existing diabetes and hypertension on autonomic function.
    • To identify which condition, diabetes or hypertension, exerts a greater impact on heart rate variability.

    Main Methods:

    • A comparative study involving four age-matched groups: type 2 diabetic patients with/without hypertension, non-diabetic hypertensive patients, and healthy controls.
    • Autonomic function was evaluated using standard cardiovascular reflex tests.
    • 24-hour ambulatory electrocardiogram (ECG) recordings were analyzed for heart rate variability using time-domain (triangular index) and frequency-domain (spectral analysis) parameters.

    Main Results:

    • Diabetes significantly reduced all measured heart rate variability parameters, including the triangular index, low-frequency (LF), high-frequency (HF) components, and total power (p < 0.001).
    • Hypertension primarily affected the low-frequency component of heart rate variability (p < 0.05).
    • Both conditions negatively impacted beat-to-beat variation during deep breathing, with additive effects observed for diabetes and hypertension.

    Conclusions:

    • Diabetes exerts a more profound negative effect on autonomic dysfunction and heart rate variability compared to hypertension.
    • Patients with concurrent diabetes and hypertension exhibit the greatest risk for diminished heart rate variability.
    • Proactive evaluation of autonomic nerve function is recommended for diabetic patients, particularly those with co-existing hypertension.
    Abstract

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