Clinical Implications of Baroreflex Sensitivity in Type 2 Diabetes

Sakamoto, Masaya; Matsutani, Daisuke; Kayama, Yosuke

doi:10.1536/ihj.18-455

Cited by 10 publications

(9 citation statements)

References 80 publications

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“…A blunted baroreflex gain is predictive of increased cardiovascular risk in patients with myocardial infarction and heart failure (11,16). Evidence has also emerged suggesting that BRS could be a marker of CAN in patients with longer-term diabetes (17)(18)(19)(20)(21)(22). However, the temporal sequence of BRS early in the course of both type 1 and type 2 diabetes remains unclear.…”

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confidence: 99%

Impairment in Baroreflex Sensitivity in Recent-Onset Type 2 Diabetes Without Progression Over 5 Years

et al. 2020

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Impaired baroreflex sensitivity (BRS) predicts cardiovascular mortality and is prevalent in long-term diabetes. We determined spontaneous BRS in patients with recentonset diabetes and its temporal sequence over 5 years by recording beat-to-beat blood pressure and R-R intervals over 10 min. Four time domain and four frequency domain BRS indices were computed in participants from the German Diabetes Study baseline cohort with recent-onset type 1/type 2 diabetes (n 5 206/381) and age-matched glucose-tolerant control subjects (control 1/control 2: n 5 65/83) and subsets of consecutive participants with type 1/type 2 diabetes who reached the 5-year follow-up (n 5 84/137). Insulin sensitivity (Mvalue) was determined using a hyperinsulinemic-euglycemic clamp. After appropriate adjustment, three frequency domain BRS indices were reduced in type 2 diabetes compared with control 2 and were positively associated with the M-value and inversely associated with fasting glucose and HbA 1c (P < 0.05), whereas BRS was preserved in type 1 diabetes. After 5 years, a decrease in one and four BRS indices was observed in patients with type 1 and type 2 diabetes, respectively (P < 0.05), which was explained by the physiologic age-dependent decline. Unlike patients with well-controlled recentonset type 1 diabetes, those with type 2 diabetes show early baroreflex dysfunction, likely due to insulin resistance and hyperglycemia, albeit without progression over 5 years.

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confidence: 99%

Impairment in Baroreflex Sensitivity in Recent-Onset Type 2 Diabetes Without Progression Over 5 Years

et al. 2020

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“…Our data further support a wealth of research that shows cBRS declines with age (Monahan 2007 ; Xing et al 2017 ; Smirl et al 2014 ; O'Mahony et al 2000 ; La Rovere et al 2008 ). We provide evidence that CVD risk factors are linked to reduced cBRS (Skrapari et al 2007 ; Sakamoto et al 2019 ; Madden et al 2010 ) and cBRS across a broad age range in females is reduced in post-menopausal women compared to pre-menopausal (Barnes et al 2012 ). We provide some evidence that this is could be explained by age, rather than the menopause accelerating any decline in cBRS.…”

Section: Discussionmentioning

confidence: 72%

The impact of age, sex, cardio-respiratory fitness, and cardiovascular disease risk on dynamic cerebral autoregulation and baroreflex sensitivity

et al. 2022

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Background Humans display an age-related decline in cerebral blood flow and increase in blood pressure (BP), but changes in the underlying control mechanisms across the lifespan are less well understood. We aimed to; (1) examine the impact of age, sex, cardiovascular disease (CVD) risk, and cardio-respiratory fitness on dynamic cerebral autoregulation and cardiac baroreflex sensitivity, and (2) explore the relationships between dynamic cerebral autoregulation (dCA) and cardiac baroreflex sensitivity (cBRS). Methods 206 participants aged 18–70 years were stratified into age categories. Cerebral blood flow velocity was measured using transcranial Doppler ultrasound. Repeated squat-stand manoeuvres were performed (0.10 Hz), and transfer function analysis was used to assess dCA and cBRS. Multivariable linear regression was used to examine the influence of age, sex, CVD risk, and cardio-respiratory fitness on dCA and cBRS. Linear models determined the relationship between dCA and cBRS. Results Age, sex, CVD risk, and cardio-respiratory fitness did not impact dCA normalised gain, phase, or coherence with minimal change in all models (P > 0.05). cBRS gain was attenuated with age when adjusted for sex and CVD risk (young–older; β = − 2.86 P < 0.001) along with cBRS phase (young–older; β = − 0.44, P < 0.001). There was no correlation between dCA normalised gain and phase with either parameter of cBRS. Conclusion Ageing was associated with a decreased cBRS, but dCA appears to remain unchanged. Additionally, our data suggest that sex, CVD risk, and cardio-respiratory fitness have little effect.

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“…This study suggested that the relatively constant BRS during acute hyperglycemia is maintained at the expense of increased oscillations in the ramp of BP and RR-interval. However, conventional parameters of BRS have been shown to be significantly affected in chronic hyperglycemic states [18,19].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Blood Pressure Variability is Better Associated with Acute Relative Hyperglycemia Than the Heart Rate Variability in Healthy Young Adults

Prakash,

Ranjan,

Malhotra

2024

Exp Clin Endocrinol Diabetes

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Background: Deranged cardiovascular autonomic functions are well-reported complications of diabetes mellitus where chronic hyperglycemia is one of the important factors. But, the role of acute relative hyperglycemia on cardiovascular autonomic functions in healthy subjects is less explored. Hardly any study has reported the effect of acute hyperglycemia on blood pressure variability. Therefore, the present study was planned to study the effect of acute relative hyperglycemia on cardiovascular autonomic functions in healthy young adults. Methods: Beat-to-beat blood pressure and electrocardiogram were recorded for the assessment of heart rate variability and blood pressure variability in forty-two young, healthy subjects during fasting and relative hyperglycemic states. Recorded cardiovascular parameters were analyzed in time and frequency domains. Correlations among analyzed parameters of cardiovascular autonomic variabilities were explored during fasting and relative hyperglycemic state. Results: We observed significant alteration of few of the systolic, mean and diastolic blood-pressure-variability-parameters during acute relative hyperglycemia when compared to the fasting state. However, no significant changes were observed in any of the heart-rate-variability parameters. Also, we found novel significant correlations among many of the parameters of cardiovascular autonomic variabilities during fasting and relative hyperglycemic states. Conclusions: Present study concludes that the blood pressure variability is affected significantly during acute relative hyperglycemia in healthy young adults, however, the heart rate variability does not show such changes. Also, many of the parameters of blood pressure variability show significant correlations with heart rate variability and baroreflex sensitivity. We may hypothesize that although the heart rate variability and blood pressure variability assess cardiovascular autonomic functions, blood pressure variability is a better indicator of cardiovascular autonomic effects of acute relative hyperglycemia than heart rate variability.

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Clinical Implications of Baroreflex Sensitivity in Type 2 Diabetes

Cited by 10 publications

References 80 publications

Impairment in Baroreflex Sensitivity in Recent-Onset Type 2 Diabetes Without Progression Over 5 Years

Impairment in Baroreflex Sensitivity in Recent-Onset Type 2 Diabetes Without Progression Over 5 Years

The impact of age, sex, cardio-respiratory fitness, and cardiovascular disease risk on dynamic cerebral autoregulation and baroreflex sensitivity

Blood Pressure Variability is Better Associated with Acute Relative Hyperglycemia Than the Heart Rate Variability in Healthy Young Adults

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