This article is more than 5 years old. Information may no longer be current.
Heart rate recovery predicts diabetes risk
In healthy adults, each 10 beats per minute decrement in attenuated heart rate recovery increases the risk for incident diabetes by 29%, independent of traditional cardiovascular disease risk factors, such as age, BMI or fasting blood glucose, according to a meta-analysis.
Heart rate recovery — the reduction in heart rate from the peak rate attained during exercise to the rate attained in the minutes after the cessation of exercise — has been recognized as a noninvasive measure of autonomic function, Shanhu Qiu, MD, of the department of endocrinology at Southeast University School of Medicine in Nanjing, China, and colleagues wrote in the study background. Recently, evidence has suggested that attenuated heart rate recovery may carry prognostic power in predicting the risk for diabetes, they wrote.
“On the one hand, autonomic dysfunction is often present in people with newly diagnosed diabetes,” the researchers wrote. “On the other hand, autonomic dysfunction will theoretically lead to an insufficient insulin secretion in response to elevated circulating glucose levels because of the potentially impaired capability of parasympathetic fibers in stimulating the pancreatic beta cells to release insulin.”
Qiu and colleagues analyzed data from four studies conducted in South Korea and the U.S. assessing 1-minute or 2-minute heart rate recovery after an exercise test in drug-naive adults without pre-existing disease (n = 9,113; mean age, 43 years; mean BMI, 24.1 kg/m²). Included studies reported incident cases of diabetes (n = 430) during a mean follow-up period of 8.1 years.
In random-effects meta-analysis, researchers found that the slowest heart rate recovery was associated with a higher risk for diabetes (HR = 1.66; 95% CI, 1.16-2.38) than the fastest heart rate recovery group. Additionally, for every 10-bpm decrement in heart rate recovery, researchers observed a 29% increased risk for diabetes (95% CI, 1.13-1.48).
Heart rate recovery as a predictor of diabetes risk remained significant in studies controlling for age, BMI, smoking status, physical fitness or at least three traditional CV risk factors. The risk for diabetes associated with the slowest heart rate recovery persisted regardless of the exercise workloads used for heart rate recovery measurement (P < .05 for all), according to researchers.
The findings support a recommendation to measure heart rate recovery as part of diabetes risk assessment in clinical routines, they wrote.
“Further studies are required to determine specific thresholds of attenuated [heart rate recovery] at different recovery time points, as well as to investigate whether interventions targeted at improving [heart rate recovery] would lead to a reduced risk of diabetes in the general or diseased populations in different countries,” the researchers wrote. – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.