Solanki Jayesh D, Hirani Chetna N, Vohra Adnan S, Panjwani Sunil J, Senta Vatsal M, Rudani Darshit K
Department of Physiology, Government Medical College, Bhavnagar, Gujarat, India.
Government Medical College, Baroda, India.
Niger Med J. 2023 Jul 2;64(3):373-381. eCollection 2023 May-Jun.
Diabetes and hypertension are known to co-exist frequently as adverse cardiovascular risk factors. Both can produce cardiac autonomic neuropathythat can be measured by ECG RR interval-based heart rate variability (HRV). We compared 5 minutes HRV in four groups based on diabetes and hypertension.
A cross sectional study was done on 203 participants divided into four groups- diabetics, hypertensives, diabetic-hypertensives and normotensive-nondiabetics. They were evaluated for current disease control and five minutes HRV was done in supine condition following standard protocols by Variowin HR Software. HRV parameters of time domain, frequency domain and Poincare plot were compared between groups and associated with gender, glycaemic control and blood pressure control. Statistical significance was set at p<0.05.
Three diseasedgroups had mean age in mid-fifties, mean duration of disease > 6 years, comparable BMI, poor glycaemic and blood pressure control. As compared to normal groups, three diseased groups exhibit reduced HRV with respect to all three domains of HRV with varying statistical significance. Among diseased groups, HRV was associated with blood pressure control better than glycaemic control but not with gender. LF /HF ratio was the most consistent HRV parameter showing statistical significance in tests.
HRV is reduced in both diabetics more than hypertensives; related to blood pressure control more than glycaemic control. It points altered cardiac autonomic balance, and possibility of cardiovascular risk and early detection of it with timely intervention. It also calls for investigation of same for reinforcement of our observations and further exploration.
糖尿病和高血压作为不良心血管危险因素经常并存。两者均可导致心脏自主神经病变，可通过基于心电图RR间期的心率变异性（HRV）进行测量。我们根据糖尿病和高血压情况将四组患者的5分钟HRV进行了比较。
对203名参与者进行了横断面研究，将他们分为四组——糖尿病患者、高血压患者、糖尿病合并高血压患者和血压正常且无糖尿病患者。评估他们目前的疾病控制情况，并按照标准方案，使用Variowin HR软件在仰卧位条件下进行5分钟HRV检测。比较各组之间时域、频域和庞加莱图的HRV参数，并将其与性别、血糖控制和血压控制相关联。设定统计学显著性为p<0.05。
三个患病组的平均年龄在五十多岁，平均病程>6年，BMI相当，血糖和血压控制不佳。与正常组相比，三个患病组在HRV的所有三个领域均表现出HRV降低，且具有不同的统计学显著性。在患病组中，HRV与血压控制的相关性优于血糖控制，但与性别无关。低频/高频比值是在测试中显示出统计学显著性的最一致的HRV参数。
糖尿病患者的HRV降低程度超过高血压患者；与血压控制的相关性大于血糖控制。这表明心脏自主神经平衡发生改变，存在心血管风险及早期发现并及时干预的可能性。这也呼吁对此进行研究以加强我们的观察并进一步探索。
