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Indian Asians have poorer cardiovascular autonomic function than Europeans: this is due to greater hyperglycaemia and may contribute to their greater risk of heart disease
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Indian Asians have poorer cardiovascular autonomic function than Europeans: this is due to greater hyperglycaemia and may contribute to their greater risk of heart disease
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Journal Article
Indian Asians have poorer cardiovascular autonomic function than Europeans: this is due to greater hyperglycaemia and may contribute to their greater risk of heart disease
2010
Overview
Aims/hypothesis A high prevalence of diabetes contributes to excess CHD in Indian Asians, but the underlying mechanisms are unclear. Heart rate, heart rate variability (HRV) and baroreflex sensitivity (BRS) are measures of cardiac autonomic function that are disturbed by hyperglycaemia and predict CHD. We compared these measures in Indian Asians and Europeans, and sought explanations for the observed differences. Methods A representative sample of 149 Europeans and 151 Indian Asians was recruited from primary care, 66% of them men (aged 35-75 years), 34% women (aged 55-75 years). Heart rate, HRV, BRS and cardio-metabolic profiles were measured over four successive 5 min periods with continuous ECG and blood pressure monitoring. Results Indian Asians were hyperglycaemic compared with Europeans (HbA₁c (mean ± SD) 6.5 ± 1.2% vs 5.9 ± 1.0%, p = 0.001). They had shorter mean RR intervals ((mean ± SE) 969 ± 13 vs 1,022 ± 12 ms, p = 0.002), lower total RR interval power ((geometric mean, 95% CI) 925 [796-1075] vs 1,224 [1,064-1,422] ms², p = 0.008) and lower BRS ((mean ± SE) 5.7 ± 1.0 vs 6.6 ± 1.0 ms/mmHg, p = 0.01). All measures of cardiac autonomic dysfunction were significantly associated with hyperglycaemia (mean RR interval vs HbA₁c r = −0.22; p < 0.001). Ethnic differences in cardiac autonomic function persisted after adjustment for age, blood pressure and medication (mean RR interval 973 vs 1,021 ms, p = 0.004), but were attenuated or abolished by adjusting for HbA₁c (979 vs 1,014 ms, p = 0.06) or other markers of hyperglycaemia. Conclusions/interpretation Indian Asians from the general population have impaired cardiovascular autonomic function compared with Europeans. This is due to greater hyperglycaemia in Indian Asians and may determine their increased CHD risk.
Publisher
Berlin/Heidelberg : Springer-Verlag,Springer-Verlag,Springer,Springer Nature B.V
Subject
/ Aged
/ Asian Continental Ancestry Group
/ Asians
/ Autonomic Nervous System - physiology
/ Biological and medical sciences
/ Diabetes. Impaired glucose tolerance
/ Endocrine pancreas. Apud cells (diseases)
/ Etiopathogenesis. Screening. Investigations. Target tissue resistance
/ European Continental Ancestry Group
/ Female
/ Heart Diseases - physiopathology
/ Humans
/ Hyperglycemia - physiopathology
/ Male
/ Medicine
