The risk of elevated resting heart rate on the development of type 2 diabetes in patients with clinically manifest vascular diseases
RH Bemelmans, AM Wassink, Y Van der Graaf... - European Journal of ..., 2012 - EFESObjective. Sympathetic nerve activation is causally related to insulin resistance as both a cause and a consequence. Resting heart rate (RHR) reflects sympathetic nerve activity. We investigated the influence of RHR on the incidence of type 2 diabetes mellitus (T2DM) in ...
Objective. Sympathetic nerve activation is causally related to insulin resistance as both a cause and a consequence. Resting heart rate (RHR) reflects sympathetic nerve activity. We investigated the influence of RHR on the incidence of type 2 diabetes mellitus (T2DM) in patients with clinically manifest vascular diseases.
Methods. RHR was obtained from an electrocardiogram. Patients were followed for incident type 2 diabetes (n=289) during a median follow-up of 5.5 (interquartile range 3.2-8.4) years. The relation between RHR and incident T2DM was estimated by Cox proportional hazard analysis. As age was an effect modifier (p=0.048), analyses were stratified for age.
Results. Patients in quartile 4 of RHR had a 65% increased risk of T2DM compared to patients in quartile 1 (reference) (HR 1.65; 95% confidence interval (95%CI) 1.15-2.36) adjusted for age, gender, smoking, estimated glomerular filtration rate, systolic blood pressure, location of vascular disease and antihypertensive medication. Every 10 beats/minute increase in RHR increased the risk for T2DM with 10% (HR 1.10; 95%CI 1.00-1.21) in the total population. This risk was particularly high in subjects 55-63 years old (per 10 beats/minute: HR 1.22; 95%CI 1.04-1.43) and was independent of the location of vascular disease and of beta-blocker use.
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The risk of elevated resting heart rate on the development of type 2 diabetes in patients with clinically manifest vascular diseases |
