January 03, 2019
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Change in resting heart rate accelerates 'vicious circle' of diabetes development

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Larger increases in resting heart rate can lead to greater risk for developing type 2 diabetes, whereas reductions can have the opposite effect, according to findings published in Nutrition, Metabolism and Cardiovascular Diseases.

“Heart rate is a simple and accessible clinical cardiovascular parameter. Over the last 35 years, numerous epidemiologic studies confirmed that resting heart rate is associated with all-cause and cardiovascular mortality in the general population and in patients with various cardiovascular diseases,” Dongsheng Hu, MD, MPH, PhD, of the department of preventive medicine at Shenzhen University Health Science Center in China, and colleagues wrote. “However, the association between [resting heart rate] and type 2 diabetes mellitus is still not fully understood in the general population.”

Researchers assessed 17,265 adults (median age, 51 years; 62.1% women) recruited as part of the Rural Chinese Cohort Study in July and August 2007 and 2008. The cohort then underwent follow-up examinations between July and August 2013 and July and October 2014. At baseline and follow-up, the researchers collected data pertaining to heart rate as well as demographics, socioeconomic factors, smoking and alcohol consumption, physical activity, medical history, BMI, blood pressure and fasting glucose levels.

The risk for type 2 diabetes development was positively associated with a change in resting heart rate (RR = 1.03; 95% CI, 1.03-1.04). Using a change in resting heart rate of between –5 and 5 beats per minute as reference, the researchers found that the risk for type 2 diabetes was lower when resting heart rate was reduced by 10 or more beats per minute (RR = 0.69; 95% CI, 0.55-0.86) and between 5 and 10 beats per minute (RR = 0.9; 95% CI, 0.73-1.11). Conversely, an increase in resting heart rate of between 5 and 10 beats per minute (RR = 1.31; 95% CI, 1.07-1.61) and an increase of more than 10 beats per minute (RR = 1.9; 95% CI, 1.59-2.26) elevated the risk for type 2 diabetes.

When stratifying by age group, the researchers found that adults aged 18 to 39 years with a change in resting heart rate of 10 or more beats per minute had an elevated risk for type 2 diabetes (RR = 2.83; 95% CI, 1.62-4.93) compared with a stable resting heart rate, which was defined as between –5 and 5 beats per minute. The risk for type 2 diabetes was lower when the change in resting heart rate was decreased by 10 or more beats per minute (RR = 0.36; 95% CI, 0.16-0.79).

In participants aged 40 to 50 years, increases of between 5 and 10 beats per minute (RR = 1.42; 95% CI, 1.12-1.8) and more than 10 beats per minute (RR = 1.81; 95% CI, 1.45-2.26) were linked to an increase in type 2 diabetes risk, whereas the researchers noted a protective effect of a reduction of 10 or more beats per minute (RR = 0.61; 95% CI, 0.45-0.83). For participants aged 60 years or older, an increase in resting heart rate led to a higher risk for developing type 2 diabetes, but a reduction did not significantly lower the risk.

“There are several biological mechanisms by which sympathetic activation causes both acute and chronic insulin resistance and may predispose to diabetes,” the researchers wrote. “Additionally, relatively high [resting heart rate] is often found together with increased blood pressure, atherogenic blood lipid profile, inflammation, obesity and metabolic syndrome. These dysfunctions and diabetes seem to operate in a vicious circle in their causal relations, and elevated [resting heart rate] and high blood pressure may be intermediate accelerators of the vicious circle.” – by Phil Neuffer

Disclosures: The authors report no relevant financial disclosures.