Glucose tolerance and other determinants of cardiovascular autonomic function: the Hoorn Study
Open accessAbstract
Aims/hypothesis Currently, three categories of measures are used to assess cardiovascular autonomic dysfunction: measures of the Ewing-test, measures of heart-rate variability, and measures of baroreflex sensitivity. We studied the determinants of these measures obtained from cardiovascular autonomic function tests in the Hoorn Study.Methods The study group (n = 631) consisted of a glucose-tolerance-stratified sample from a 50- to 75-year-old group of people. Cardiac cycle duration (RR interval) and continuous finger arterial pressure were measured under three conditions: during (a) spontaneous breathing, (b) six deep breaths over one minute, and (c) an active change in position from lying to standing. From these readings, ten measures of autonomic function were assessed (three Ewing, six heart-rate variability and one baroreflex sensitivity). As possible determinants we considered age, sex, glucose tolerance, cardiovascular disease, use of anti-hypertensive drugs, anthropometric factors, metabolic factors and lifestyle factors.Results Multivariate analysis showed that eight of ten cardiovascular autonomic function measures were most strongly associated with glucose tolerance. Furthermore, measures were moderately associated with age, sex, waist-to-hip ratio, use of anti-hypertensive drugs, and insulin. The measures were weakly associated with coronary artery disease but not with lipids. The strongest determinants seemed to differ between subjects with and without diabetes: in the non-diabetic subjects the most strongly associated were age and use of anti-hypertensive drugs and in subjects with diabetes, insulin. No consistent differences in association between the three categories of measures were observed.Conclusion/interpretation The strongest determinants of autonomic function were age, presence of diabetes and use of anti-hypertensive drugs.
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Prediabetes has been found to be associated with decreased heart rate variability, decreased postural changes in heart rate, increased prevalence of erectile dysfunction among men, and a worse profile in tests of sympathetic and parasympathetic function.
“Prediabetes has been found to be associated with decreased heart rate variability61 (HRV – a marker of parasympathetic function),62–65, decreased postural changes in heart rate,62 increased prevalence of erectile dysfunction among men,66 and a worse profile in tests of sympathetic and parasympathetic function.67”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [63]
No consistent evidence is available to suggest that prediabetes is associated with measurements of orthostatic blood pressure changes or with decreased expiratory-inspiratory ratio or change in heart rate during breathing.
“No consistent evidence is available to suggest that prediabetes is associated with measurements of orthostatic blood pressure changes,63 which is a late marker of diabetic neuropathy,61 or with decreased expiratory-inspiratory ratio or change in heart rate during breathing.63”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [63]
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- Authors
- Gerritsen, J., Dekker, J. M., TenVoorde, B. J., Bertelsmann, F. W., Kostense, P. J., Stehouwer, C. D. A., Heine, R. J., Nijpels, G., Heethaar, R. M., & Bouter, L. M.
- Affiliations
- Vrije Universiteit Amsterdam (NL)
- Ziekenhuis Amstelland (NL)
- Venue
- Diabetologia
- Published
- 2000-05-02
- Volume
- 43
- Issue
- 5
- Pages
- 561-570
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W2105469133
- Cited by
- 121
- References
- 43
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 4 · 2022: 2 · 2021: 3 · 2020: 4 · 2019: 6 · 2018: 3 · 2017: 1 · 2016: 4 · 2015: 8 · 2014: 6 · 2013: 4 · 2012: 10
- FWCI
- 3.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- Funders
- Diabetes Fonds
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- cardiac autonomic function, glucose tolerance, Ewing test, heart rate variability, baroreflex sensitivity, diabetes mellitus, antihypertensive drugs, insulin, age, waist-to-hip ratio, coronary artery disease, older adults, Hoorn Study
- MeSH terms
- Aged, Aging, Anthropometry, Antihypertensive Agents, Autonomic Nervous System Diseases, Blood Pressure, Cardiovascular Diseases, Cardiovascular System, Diabetes Mellitus, Female, Humans, Insulin, Life Style, Male, Middle Aged, Posture, Prospective Studies, Respiration, Risk Factors, Cohort Studies, Glucose Intolerance
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