Heart rate as marker of sympathetic activity

Grassı, Guıdo; Vailati, Silvia; Bertinieri, G.; Seravalle, Gino; Stella, Massimo; Dell’Oro, Raffaella; Mancia, Giuseppe

doi:10.1097/00004872-199816110-00010

Cited by 252 publications

(186 citation statements)

References 17 publications

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“…However, the precise nature of the pathophysiological relationship underlying the increased risk of hyperglycaemia in those with an elevated heart rate has not been explained. Resting heart rate is a marker of the autonomic nervous system, with elevated heart rate reflecting a shift in autonomic balance toward enhanced sympathetic nervous activity and reduced vagal tone (21). Some evidence suggests that sympathetic activation contributes to the development of insulin resistance in humans (7,8,22,23).…”

Section: Discussionmentioning

confidence: 99%

Elevated heart rate predicts β cell function in non-diabetic individuals: the RISC cohort

Bonnet¹,

Empana²,

Natali³

et al. 2015

European Journal of Endocrinology

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Context: Elevated heart rate has been associated with insulin resistance and incident type 2 diabetes but its relationship with b-cell function is not known. Our aim was to investigate whether baseline heart rate is associated with b-cell function and hyperglycaemia. Methods: We used the prospective RISC cohort with 1005 non-diabetic individuals who had an oral glucose tolerance test (OGTT) at baseline and after 3 years. Impaired glucose regulation was defined as a fasting plasma glucose R6.1 mmol/l or a 2-h plasma glucose R7.8 mmol/l. Insulin sensitivity was assessed by the OGIS index and insulin secretion and b-cell glucose sensitivity at both baseline and 3 years. Results: Baseline heart rate was positively related to both fasting (P!0.0001) and 2 h glucose levels (PZ0.02) at year 3 and predicted the presence of impaired glucose regulation at year 3 in a logistic regression model adjusting for insulin sensitivity at inclusion (OR/10 beats per min: 1.31; 95% CI (1.07-1.61); PZ0.01). Baseline heart rate was associated with lower insulin sensitivity (bZK0.11; P!.0001), a decrease in both b-cell glucose sensitivity (bZK0.11; PZ0.003) and basal insulin secretion rate (bZK0.11; PZ0.002) at 3 years in an adjusted multivariable regression model. Baseline heart rate predicted the 3-year decrease in b-cell glucose sensitivity (bZK0.10; PZ0.007) and basal insulin secretion (bZK0.12; PZ0.007). Conclusions: Heart rate predicts b-cell function and impaired glucose regulation at 3 years in non-diabetic individuals, independently of the level of insulin sensitivity. These findings suggest a possible effect of the sympathetic nervous system on b-cell dysfunction, which deserves further investigation.

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Section: Discussionmentioning

confidence: 99%

Elevated heart rate predicts β cell function in non-diabetic individuals: the RISC cohort

Bonnet¹,

Empana²,

Natali³

et al. 2015

European Journal of Endocrinology

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“…RHR is an indicator of sympathetic activity (12) and an increased sympathetic nerve system induces both acute and chronic insulin resistance (9, 10, 11). The major organs involved in insulin Table 2 The risk of RHR per 10 bpm on incident T2DM in patients with clinically manifest vascular diseases, after stratification in three age groups.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, chronically increased sympathetic nerve activity can precede the development of insulin resistance and obesity (10,11). RHR reflects sympathetic tone, and correlates with muscle sympathetic nerve activity and noradrenaline serum levels (12). An increased RHR identifies subjects at higher risk for developing cardiovascular disease and mortality (13,14).…”

Section: Introductionmentioning

confidence: 99%

Risk of elevated resting heart rate on the development of type 2 diabetes in patients with clinically manifest vascular diseases

Bemelmans

Wassink²,

Graaf³

et al. 2012

European Journal of Endocrinology

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Objective: Sympathetic nerve activation is causally related to insulin resistance as both a cause and a consequence. Resting heart rate (RHR) reflects sympathetic nerve activity. We investigated the effect of RHR on the incidence of type 2 diabetes mellitus (T2DM) in patients with clinically manifest vascular diseases. Design: Data were used from the second manifestations of arterial disease (SMART) study: a prospective cohort study of patients with clinically manifest vascular diseases (nZ3646). Methods: RHR was obtained using an electrocardiogram. Patients were followed up for incident type 2 diabetes (nZ289) during a median period of 5.5 (interquartile range 3.2-8.4) years. The relation between RHR and incident T2DM was estimated by Cox proportional hazard analysis. As age was an effect modifier (PZ0.048), analyses were stratified for age. Results: Patients in quartile 4 (Q4) of RHR had a 65% increased risk of T2DM compared with those in Q1 (reference; hazard ratios (HR), 1.65; 95% confidence interval (95% CI), 1.15-2.36) adjusted for age, gender, smoking, estimated glomerular filtration rate, systolic blood pressure, location of vascular disease, and antihypertensive medication. Every 10 beats per minute (bpm) increase in RHR increased the risk for T2DM with 10% (HR, 1.10; 95% CI, 1.00-1.21) in the total population. This risk was particularly high in subjects aged 55-63 years (per 10 bpm: HR, 1.22; 95% CI, 1.04-1.43) and was independent of the location of vascular disease and beta-blocker use. Conclusions: Increased RHR, an indicator of sympathetic nerve activity, is associated with an increased risk for T2DM in patients with manifest vascular diseases, particularly in middle-aged patients.

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“…In patients with hypertension, MSNA has been reported to be higher than [5][6][7] or similar to 8 -10 measurements in normotensive control subjects. Studies in normal subjects have reported that MSNA is linked to heart rate (HR) 11 but is unrelated to blood pressure. 12,13 The link between HR and blood pressure is more compelling.…”

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confidence: 99%

Interactive Effect of Heart Rate and Muscle Sympathetic Nerve Activity on Blood Pressure

Narkiewicz

Somers

1999

Circulation

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Background-Sympathetic traffic to the peripheral vasculature and sympathetic discharge to the heart have complementary effects on blood pressure. Although faster heart rates have been linked to higher blood pressures, the relationship between muscle sympathetic nerve activity (MSNA) and long-term regulation of blood pressure is not clear. We tested the hypothesis that MSNA and heart rate are linked to blood pressure levels in normotensive subjects. Methods and Results-We studied normal young male (nϭ120) and female (nϭ48) subjects subdivided according to tertiles of heart rate and MSNA distributions. Systolic, diastolic, and pulse pressures were significantly different across the heart rate tertiles in male subjects, with the highest blood pressure values in the upper tertile of heart rate. No significant differences in blood pressure across the tertiles of MSNA were found. The relationship between MSNA and blood pressure, however, was affected by heart rate. MSNA did not influence blood pressure in the first and second heart rate tertiles. However, within the upper heart rate tertile, subjects with higher levels of MSNA had significantly higher systolic (Pϭ0.02) and pulse (Pϭ0.004) pressures than subjects with lower levels of MSNA. In female subjects, blood pressure was not different across the tertiles of heart rate or MSNA. Conclusions-MSNA and heart rate have interactive effects on systolic blood pressure and pulse pressure in normotensive male but not female subjects. No relationship between MSNA and blood pressure or pulse pressure is evident in subjects with slower heart rate. In male subjects with faster heart rates, higher levels of MSNA are associated with higher systolic and pulse pressures. (Circulation. 1999;100:2514-2518.)

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Heart rate as marker of sympathetic activity

Cited by 252 publications

References 17 publications

Elevated heart rate predicts β cell function in non-diabetic individuals: the RISC cohort

Elevated heart rate predicts β cell function in non-diabetic individuals: the RISC cohort

Risk of elevated resting heart rate on the development of type 2 diabetes in patients with clinically manifest vascular diseases

Interactive Effect of Heart Rate and Muscle Sympathetic Nerve Activity on Blood Pressure

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