Issue 123 Item 9 Decreased Heart Rate Variability In Diabetics A Risk Factor For

Decreased heart rate variability in diabetics appears to be an independent risk factor for mortality. S. Wheeler and colleagues at the Veterans Affairs Puget Sound Health Care System, in Seattle, Washington, United States, investigated whether autonomic neuropathy predicts short term all-cause mortality in an elderly cohort of veteran patients with diabetes.

The study included 843 of the diabetic patients who received primary care at the Veterans Affairs hospital between 1990 and 1997. The patients’ autonomic neuropathy was evaluated by heart rate response to timed deep breathing. The mean follow-up was 42.4 months. One hundred and fifty one patients died since the onset of the study, the researchers noted.

The Cox proportional hazards analysis, adjusting for age, smoking status, creatinine, pack-years of cigarettes smoked, diabetes duration, race, history of ischemic heart disease and hypertension, showed that patients with the lowest quintile of heart rate variability had a significantly increased risk of mortality, the investigators reported. The hazard ratio was 1.49 with 95 percent confidence limits of 1.01 to 2.19.

"This study supports the hypothesis that decreased heart rate variability is an independent risk factor for mortality in diabetic patients followed in a primary care setting," the researchers concluded.
Diabetes Res Clin Pract 2002; 58: 131