Decreased heart rate variability in patients with type 1 diabetes mellitus is related to arterial wall stiffness

J Intern Med. 1999 Jan;245(1):57-61. doi: 10.1046/j.1365-2796.1999.00402.x.


Objective: Low heart rate variability (HRV) is, in several patient groups, related to poor prognosis. The underlying mechanisms are still unclear. The aim was to study if there is a relationship between HRV, which is a measure of baroreceptor function, and atherosclerosis.

Design: The relationship between heart rate variability and carotid arterial wall stiffness was studied in subjects with type 1 diabetes mellitus in which autonomic dysfunction and early atherosclerosis are common. HRV was assessed from power spectral analysis of 24-h Holter recordings and arterial wall stiffness was assessed from an ultrasound study of the right common carotid artery.

Setting: A university hospital.

Subjects: Fifty-nine patients (41 +/- 8 years) from the Stockholm Diabetes Intervention Study (SDIS) were investigated. These patients were randomized to intensified conventional treatment or standard treatment approximately 12 years before this study.

Results: Patients with stiffer arteries had lower HRV in all spectral bands (r = -0.32 to -0.40, P = 0.06-0.001). This relation remained on correcting for age. All spectral parameters of HRV correlated with the mean HbA1c from 10 years of study (r = -0.37 to -0.40, P = 0.004-0.001).

Conclusions: In patients with type 1 diabetes mellitus, heart rate variability and arterial wall stiffness are related to each other. The results suggests that the autonomic nervous system could be a link between diabetes and vascular disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Arteriosclerosis / physiopathology
  • Autonomic Nervous System / physiopathology*
  • Carotid Artery, Common / diagnostic imaging
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Electrocardiography, Ambulatory
  • Female
  • Heart Rate*
  • Humans
  • Male
  • Middle Aged
  • Pressoreceptors / physiopathology
  • Ultrasonography