Association of hyperglycemia with reduced heart rate variability (The Framingham Heart Study)
Open accessAbstract
This study was designed to examine the association of heart rate variability (HRV) with blood glucose levels in a large community-based population. Previous reports have shown HRV to be reduced in diabetics, suggesting the presence of abnormalities in neural regulatory mechanisms. There is scant information about HRV across the spectrum of blood glucose levels in a population-based cohort. One thousand nine hundred nineteen men and women from the Framingham Offspring Study, who underwent ambulatory electrocardiographic recordings at a routine examination, were eligible. HRV variables included the SD of normal RR intervals (SDNN), high-frequency (HF, 0.15 to 0.40 Hz) and low-frequency (LF, 0.04 to 0.15 Hz) power, and LF/HF ratio. Fasting plasma glucose levels were used to classify subjects as normal (<110 mg/dl; n = 1, 779), as having impaired fasting glucose levels (110 to 125 mg/dl; n = 56), and as having diabetes mellitus (DM >/=126 mg/dl or receiving therapy; n = 84). SDNN, LF and HF power, and LF/HF ratio were inversely related to plasma glucose levels (p <0.0001). SDNN and LF and HF powers were reduced in DM subjects (4.28 +/- 0.03, 6.03 +/- 0. 08, and 4.95 +/- 0.09) and in subjects with impaired fasting glucose levels (4.37 +/- 0.04, 6.26 +/- 0.10, and 5.06 +/- 0.11) compared with those with normal fasting glucose (4.51 +/- 0.01, 6.77 +/- 0.02, and 5.55 +/- 0.02, all p <0.005), respectively. After adjusting for covariates (age, sex, heart rate, body mass index, antihypertensive and cardiac medications, systolic and diastolic blood pressures, smoking, and alcohol and coffee consumption), LF power and LF/HF ratio were lower in DM subjects than in those with normal fasting glucose (p <0.005). HRV is inversely associated with plasma glucose levels and is reduced in diabetics as well as in subjects with impaired fasting glucose levels. Additional research is needed to determine if low HRV contributes to the increased cardiovascular morbidity and mortality described in subjects with hyperglycemia.
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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 [64]
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Research works printed but not linked: 2
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- Authors
- Singh, J. P., Larson, M. G., O’Donnell, C. J., Wilson, P. F., Tsuji, H., Lloyd-Jones, D. M., & Levy, D.
- Affiliations
- Harvard University (US)
- Boston University (US)
- Kansai Medical University (JP)
- Corresponding author
- Levy, Daniel
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2000-08
- Volume
- 86
- Issue
- 3
- Pages
- 309-312
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W2077017015
- Cited by
- 439
- References
- 28
- Citations by year
- 2026: 3 · 2025: 13 · 2024: 26 · 2023: 23 · 2022: 17 · 2021: 17 · 2020: 26 · 2019: 20 · 2018: 15 · 2017: 19 · 2016: 19 · 2015: 22 · 2014: 19 · 2013: 21 · 2012: 31
- FWCI
- 6.67
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The American Journal of Cardiology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- 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
- heart rate variability, hyperglycemia, blood glucose, diabetes mellitus, impaired fasting glucose, autonomic nervous system, sympathetic activity, LF/HF ratio, SDNN, high-frequency power, low-frequency power, autonomic dysfunction, Framingham Offspring Study, community-based cohort, Holter monitoring, fasting blood glucose, cardiovascular risk factors, smoking, alcohol consumption
- MeSH terms
- Adult, Autonomic Nervous System, Blood Glucose, Coronary Disease, Diabetes Mellitus, Diabetic Neuropathies, Electrocardiography, Female, Heart, Heart Rate, Humans, Hyperglycemia, Male, Middle Aged, Prospective Studies, Risk Factors, Electrocardiography, Ambulatory, Death, Sudden, Cardiac
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