Cardiometabolic & kidneySecondary analysis
Circadian heart rate fluctuations predict cardiovascular and all-cause mortality in type 2 and type 1 diabetes: a 21-year retrospective longitudinal study
- Secondary analysis of the CHAMP1ON cohort (retrospective longitudinal study)
- 21-year observational follow-up
Authors' conclusion
Impaired circadian HR fluctuations are associated with microvascular disease and long-term cardiovascular and all-cause mortality in diabetes.
Study context
- Population
- Adults with type 1 or type 2 DM with baseline 24-h ambulatory BP and HR monitoringof 497 in cohort
- Participants
- 349 adults
- Comparison
- Low vs high 24-h HR SD; blunted vs preserved nocturnal HR dip
- Primary endpoint
- CV and all-cause mortality
- Follow-up
- 21-year follow-up
Primary result
As reported in the abstract
6251 person-years; 21.0 (14.0-21.0) years
Adjusted hazard ratio (95% CI)P value
Low 24-h HR SD vs High 24-h HR SDCV mortality
2.00(1.30–3.08)
P = 0.002Low 24-h HR SD vs High 24-h HR SDall-cause mortality
1.61(1.13–2.29)
P = 0.009Blunted nocturnal HR dip vs Preserved nocturnal HR dipCV mortality
1.63(1.08–2.46)
P = 0.019Blunted nocturnal HR dip vs Preserved nocturnal HR dipall-cause mortality
1.69(1.20–2.38)
P = 0.003- Total deaths
- 136 (39%)
- CV deaths
- 100 (68%)
Further findings
Cardiac autonomic neuropathy and nephropathy · baseline
- Low 24-h HR SD and blunted nocturnal HR dip: higher prevalence
- 12-23%
- Low 24-h HR SD and blunted nocturnal HR dip associated with adverse cardiometabolic risk profile
Original publication
Circadian heart rate fluctuations predict cardiovascular and all-cause mortality in type 2 and type 1 diabetes: a 21-year retrospective longitudinal study. Eur J Prev Cardiol. Published 26 September 2024. doi:10.1093/eurjpc/zwae305
Summarised from the published abstract; every number is checked against it