Vol 2, No 4 (2001): Practical Diabetology
Other materials agreed with the Editors
Published online: 2001-11-19
The association of heart-rate variability with cardiovascular risk factors and coronary artery calcification. A study in type 1 diabetic patients and the general population
Diabetologia Praktyczna 2001;2(4):281-298.
Abstract
INTRODUCTION. To examine the association of heart-
rate variability with cardiovascular risk factors
and coronary calcification in type 1 diabetic and nondiabetic
subjects without a history of cardiovascular
disease. Reduced heart-rate variability is associated
with increased risk of coronary events. Whether
it is associated with coronary atherosclerosis is
unknown.
MATERIAL AND METHODS. Power spectral analysis was used to define heart-rate variability in a cross- -sectional study of 160 type 1 diabetic patients and 163 randomly selected nondiabetic adults from the general population aged 3055 years. Coronary artery calcification was measured using electron beamcomputed tomography.
RESULTS. Reduced heart-rate variability was associated with similar risk factors in the diabetic and nondiabetic subjects, namely higher HbA1c, triglycerides, systolic blood pressure, BMI, and albumin excretion rate. Reduced heart-rate variability was significantly associated with coronary artery calcification in all subjects (odds ratio per tertile lower total power = 1.5; P = 0.01). This association was not independent of blood pressure or BMI (odds ratio on adjustment = 1.3; P = 0.1).
CONCLUSIONS. Reduced heart-rate variability clusters with other cardiovascular disease risk factors, especially those that are more common in the insulin resistance syndrome, and is associated with increased coronary calcification in asymptomatic young adults. Whether reduced heart-rate variability leads to other risk factor disturbances or mediates the effects of other risk factors on atherosclerosis deserves further study.
MATERIAL AND METHODS. Power spectral analysis was used to define heart-rate variability in a cross- -sectional study of 160 type 1 diabetic patients and 163 randomly selected nondiabetic adults from the general population aged 3055 years. Coronary artery calcification was measured using electron beamcomputed tomography.
RESULTS. Reduced heart-rate variability was associated with similar risk factors in the diabetic and nondiabetic subjects, namely higher HbA1c, triglycerides, systolic blood pressure, BMI, and albumin excretion rate. Reduced heart-rate variability was significantly associated with coronary artery calcification in all subjects (odds ratio per tertile lower total power = 1.5; P = 0.01). This association was not independent of blood pressure or BMI (odds ratio on adjustment = 1.3; P = 0.1).
CONCLUSIONS. Reduced heart-rate variability clusters with other cardiovascular disease risk factors, especially those that are more common in the insulin resistance syndrome, and is associated with increased coronary calcification in asymptomatic young adults. Whether reduced heart-rate variability leads to other risk factor disturbances or mediates the effects of other risk factors on atherosclerosis deserves further study.
Keywords: heart-rate variabilityatheromatosis coronary calcificationcardiovascular risk factors