Heart rate variability is severely impaired among type 2 diabetic patients with hypertension

Ildikó Istenes, Anna Erzsébet Körei, Zsuzsanna Putz, Nóra Németh, Timea Martos, Katalin Keresztes, Miklós Soma Kempler, Vági Orsolya Erzsébet, Péter Vargha, Péter Kempler

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Introduction: The aim of our study was to evaluate the relative effect of diabetes and hypertension on heart rate variability. Research design and methods: Four age-matched groups including type 2 diabetic patients with and without hypertension, non-diabetic patients with essential hypertension and healthy control subjects were studied. Autonomic function was evaluated by the standard cardiovascular reflex tests and 24-hour heart rate variability measurement. Heart rate variability was characterized by the triangular index value and by the spectral components of the frequency domain analysis. Results: According to the two-way analysis of variance on ranks, all parameters were influenced negatively by diabetes (heart rate variability triangular index: p<0.001; low-frequency component: p<0.0001; high-frequency component: p<0.001; and total power: p<0.0001), whereas hypertension had a negative effect only on the low-frequency component (p<0.05). The interaction between hypertension and diabetes was not significant, indicating that their effects on the heart rate variability parameters are additive. Beat-to-beat variation upon deep breathing, the most sensitive cardiovascular reflex test was also negatively influenced by both diabetes (p<0.001) and hypertension, (p<0.05), and their effects were additive. Conclusions: Diabetes appears to have a greater effect on autonomic dysfunction compared with hypertension. Patients suffering from both diabetes and hypertension are at the highest risk of reduced heart rate variability. Early assessment of the autonomic nerve function is suggested in diabetic patients with hypertension.

Original languageEnglish
Pages (from-to)305-312
Number of pages8
JournalDiabetes/Metabolism Research and Reviews
Issue number4
Publication statusPublished - May 2014



  • Cardiovascular autonomic neuropathy
  • Heart rate variability
  • Type 2 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Istenes, I., Körei, A. E., Putz, Z., Németh, N., Martos, T., Keresztes, K., Kempler, M. S., Erzsébet, V. O., Vargha, P., & Kempler, P. (2014). Heart rate variability is severely impaired among type 2 diabetic patients with hypertension. Diabetes/Metabolism Research and Reviews, 30(4), 305-312. https://doi.org/10.1002/dmrr.2496