Impaired autonomic function is associated with increased mortality, especially in subjects with diabetes, hypertension, or a history of cardiovascular disease - The Hoorn study
| Autor: | Lex M. Bouter, Jeanet Gerritsen, Piet J. Kostense, Rob M. Heethaar, Jacqueline M. Dekker, Ben J. TenVoorde, Coen D.A. Stehouwer, Robert J. Heine |
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| Přispěvatelé: | EMGO+ - Musculoskeletal Health, EMGO+ - Lifestyle, Overweight and Diabetes, EMGO+ - Quality of Care, EMGO+ - Mental Health |
| Jazyk: | angličtina |
| Rok vydání: | 2001 |
| Předmět: |
Male
medicine.medical_specialty Endocrinology Diabetes and Metabolism Population Baroreflex Supination Diabetes Complications SDG 3 - Good Health and Well-being Heart Rate Risk Factors Internal medicine Diabetes mellitus Internal Medicine medicine Risk of mortality Heart rate variability Humans Myocardial infarction education Aged Advanced and Specialized Nursing Diabetic Autonomic Neuropathy education.field_of_study business.industry Respiration Middle Aged medicine.disease Endocrinology Blood pressure Autonomic Nervous System Diseases Cardiovascular Diseases Hypertension Cardiology Female business |
| Zdroj: | Gerritsen, J, Dekker, J M, ten Voorde, B J, Kostense, P J, Heine, R J, Bouter, L M & Heethaar, R M 2001, ' Impaired autonomic function is associated with increased mortality, especially in subjects with diabetes, hypertension, or a history of cardiovascular disease-The Hoorn study ', Diabetes Care, vol. 24, no. 10, pp. 1793-1798 . https://doi.org/10.2337/diacare.24.10.1793 Diabetes Care, 24(10), 1793-1798. American Diabetes Association Inc. |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/diacare.24.10.1793 |
| Popis: | OBJECTIVE—Measures of baroreflex sensitivity, heart rate variability (HRV), and the classical Ewing test parameters are currently used for the diagnosis of diabetic autonomic neuropathy and for mortality risk stratification after myocardial infarction. However, the strengths of the associations of these measures of autonomic function with risk of mortality have never been compared in one study population. Furthermore, no evidence is available on the possible effect of glucose tolerance on these associations. RESEARCH DESIGN AND METHODS—The study population (n = 605) consisted of a glucose tolerance–stratified sample from a general population (50–75 years of age). Cardiac cycle duration and continuous finger arterial pressure were measured under two conditions: at rest and on metronome breathing. From these readings, seven parameters of autonomic function were assessed (one Ewing, five HRV, and one baroreflex sensitivity). RESULTS—During 9 years of follow-up, 101 individuals died, 43 from cardiovascular causes. Subjects with diabetes and low levels of the autonomic function parameters, indicating impaired autonomic function, had an approximately doubled risk of mortality. This association was consistent, though not statistically significant, for all parameters. The elevated risk was not observed in subjects without diabetes, hypertension, or prevalent cardiovascular disease. CONCLUSIONS—Impaired autonomic function is associated with all-cause and cardiovascular mortality. Moreover, the results of the present study suggest that cardiac autonomic dysfunction in patients already at risk (diabetes, hypertension, or history of cardiovascular disease) may be especially hazardous. |
| Databáze: | OpenAIRE |
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