title: Comparative study of cardiac autonomic status by heart rate variability between under-treatment normotensive and hypertensive known type 2 diabetics.
abstract: BACKGROUND
  Co-existence of hypertension is known in three quarter of Indian type 2 diabetics, this duo having adverse additive effect on cardiovascular health including dysautonomia. Latter can be measured by simple 5min heart rate variability (HRV) using simple electrocardiogram, which if reduced indicates cardiac risk.
  
  
  OBJECTIVE
  We compared HRV parameters between hypertensive and normotensive type 2 diabetics, looking for significant difference if any.
  
  
  METHODS
  98 hypertensive and 40 normotensive type 2 diabetics treated as outpatients were evaluated for disease control and risk stratification. Fivemin resting HRV was measured by Variowin HR, software based instrument, using standard protocols to record time domain, frequency domain and Poincare plot parameters. They were compared between groups for difference.
  
  
  RESULTS
  Mean age was 56 and 51 years, duration 6 years and 4 years respectively in hypertensive (HT) and normotensive (NT) group of type 2 diabetics, which did not significantly differ in distribution of risk factors. There was poor glycaemic control (one third) in both groups and good pressure control in HT group. Both groups revealed all reduced HRV parameters with significant difference in-between only for LF/HF ratio (1.29 in HT vs 2.61 in NT group).
  
  
  CONCLUSIONS
  Our findings of HRV suggest that in type 2 diabetics with poor glycaemic and good pressure control, hypertension as a co-existing factor does not make significant difference in cardiac dysautonomia emphasizing residual risk despite antihypertensive treatment and need for early HRV screening, strict glycaemic control and other interventions.
authors.affiliation: Department of Physiology, Govt Medical College, Bhavnagar, Gujarat, India. Electronic address: drjaymin_83@yahoo.com.
authors.forename: Jayesh D
authors.initials: JD
authors.lastname: Solanki
authors.affiliation: Department of Physiology, Govt Medical College, Bhavnagar, Gujarat, India.
authors.forename: Sanket D
authors.initials: SD
authors.lastname: Basida
authors.affiliation: Department of Physiology, Govt Medical College, Bhavnagar, Gujarat, India.
authors.forename: Hemant B
authors.initials: HB
authors.lastname: Mehta
authors.affiliation: Department of Physiology, Govt Medical College, Bhavnagar, Gujarat, India.
authors.forename: Sunil J
authors.initials: SJ
authors.lastname: Panjwani
authors.affiliation: Department of Physiology, Govt Medical College, Bhavnagar, Gujarat, India.
authors.forename: Bhakti P
authors.initials: BP
authors.lastname: Gadhavi
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents
keywords: Dysautonomia; Heart rate variability; Hypertension; Normotensive; Type 2 diabetes