A reduction in 24-hour heart rate variations was linked to twice the risk for long-term cardiovascular death, while the inability to reduce heart rate during sleep was linked to 39% increased risk.
Participants underwent 24-hour ambulatory blood pressure monitoring and HR monitoring, as well as assessment of diabetic microvascular complications.
The median SD value of ABPM-derived HR measurements was used to define patients with low daily HR fluctuations ; a < 10% decline in average nighttime vs daytime HR identified patients with a blunted nocturnal HR dip.Low 24h-HR SD and blunted nocturnal HR dip were associated with an adverse cardiometabolic risk profile and a high prevalence of cardiacAfter a mean 21 years of follow-up, 136 deaths occurred, of which 100 had a cardiovascular cause.
After adjustment for potential confounders — including age, sex, BMI, glycemic control, diabetes type, and— the low 24h-HR SD group had double the risk for cardiovascular mortality and a 50% higher risk for all-cause mortality than the high 24h-HR SD group. Patients with a blunted nocturnal HR dip consistently had a 39% higher adjusted risk for cardiovascular and all-cause mortality than those with a preserved nocturnal HR dip.Impaired circadian HR fluctuations are associated with microvascular disease and increased long-term cardiovascular and all-cause mortality in patients with diabetes, the authors wrote."Identifying these conditions via 24h-ABPM may provide a cost-effective risk stratification tool in this high-risk population.
Heart Cardiometabolic Risk Cardiometabolic Risk Factors Body Mass Index BMI Circadian Circadian Rhythm Sleep Autonomic Neuropathy Diabetes Mellitus Type 1 Diabetes Mellitus Type I Type 1 Diabetes Type 1 DM T1DM T1D Blood Europe European Italy Italian Neuropathy Renal Disease Kidney Disease Kidney Disorder Renal Disorder Nephropathy Spain Spanish
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