Contribution of autonomic dysfunction to abnormal exercise blood pressure in type 2 diabetes mellitus

Weston, Kassia S., Sacre, Julian S., Jellis, Christine L. and Coombes, Jeff S. (2012) Contribution of autonomic dysfunction to abnormal exercise blood pressure in type 2 diabetes mellitus. Journal of Science and Medicine in Sport, 16 1: 8-12. doi:10.1016/j.jsams.2012.04.001


Author Weston, Kassia S.
Sacre, Julian S.
Jellis, Christine L.
Coombes, Jeff S.
Title Contribution of autonomic dysfunction to abnormal exercise blood pressure in type 2 diabetes mellitus
Journal name Journal of Science and Medicine in Sport   Check publisher's open access policy
ISSN 1440-2440
1878-1861
Publication date 2012-05-18
Sub-type Article (original research)
DOI 10.1016/j.jsams.2012.04.001
Volume 16
Issue 1
Start page 8
End page 12
Total pages 5
Place of publication Chatswood, NSW, Australia
Publisher Elsevier
Collection year 2013
Language eng
Formatted abstract
Objectives: The purpose of this study was to compare the presence and severity of autonomic dysfunction in type 2 diabetes mellitus patients, with and without exaggerated blood pressure responses to exercise.

Design: We performed a cross-sectional analysis of 98 patients with type 2 diabetes mellitus (aged 59 ± 9).

Method:
Both time (standard deviation of RR intervals, root-mean-square of successive RR interval differences) and frequency (total spectral power, high frequency, low frequency, very low frequency) domains of heart rate variability were analysed in a 5 min recording at rest and 20 min after a maximal treadmill test. An exaggerated blood pressure response to exercise was identified by peak blood pressure ≥190/105 mm Hg (women) or ≥210/105 mm Hg (men).

Results: Each group of either exaggerated exercise blood pressure response or normal blood pressure response consisted of 49 patients. At rest there were no significant differences between groups for all time and frequency domain parameters of heart rate variability. Post-exercise, there was a significant (p < 0.05) reduction in the SDNN, RMSSD and TP in the exaggerated exercise blood pressure group. Independent correlates (p < 0.01) of exercise systolic blood pressure included post-exercise TP, resting systolic blood pressure, cardiac autonomic neuropathy and beta-blockers (beta = -0.28, adj. R 2 = 0.32, p < 0.001).

Conclusions: Reduced post-exercise heart rate variability in patients with type 2 diabetes mellitus, with an exaggerated exercise blood pressure response suggests preclinical autonomic dysfunction characterized by impaired vagal modulation.
Keyword Diabetic neuropathies
Exaggerated blood pressure
Heart rate variability
Peak exercise
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available online: 16 May 2012.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Human Movement and Nutrition Sciences Publications
School of Medicine Publications
 
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Created: Fri, 23 Nov 2012, 10:55:38 EST by Deborah Noon on behalf of School of Human Movement and Nutrition Sciences