Impaired glucose control is associated with multiple cardiovascular impairments

Background Impairments in several markers of the cardiovascular system have been described in impaired glucose tolerance (IGT) and diabetes, but the relative importance of those is not known. We aimed to investigate which cardiovascular markers were most closely linked to an impaired glucose control. Method In a population-based study of individuals all aged 50 years, the Prospective study of Obesity, Energy and Metabolism (POEM), 502 subjects were thoroughly investigated regarding endothelial function, arterial compliance, heart rate variability, arterial blood flow and atherosclerosis, performance at an exercise test with gas exchange (VO2 and VCO2), left ventricular structure and function, lung function and multiple measurements of blood pressure. Based on an oral glucose tolerance test (OGTT), the participants were grouped into normal, IGT and diabetes. Results Of all haemodynamic and structural variables analysed, an impaired glucose control was most closely related to resting heart rate (based on chi-square value at ANOVA). Heart rate was followed by maximal workload, VO2 recovery 5 min following exercise, reflectance index at pulse wave analysis, manual systolic blood pressure, ambulatory pulse and pulse pressure, echogenicity of carotid intima-media complex at ultrasound, and pulse wave velocity (p < .0005 for all variables). All of these variables still showed p < .05 versus an impaired glucose control following adjustment for BMI. Conclusion Of multiple measured cardiovascular markers, resting heart rate was most closely related to an impaired glucose control. Also exercise capacity and the recovery in VO2 following exercise were amongst the top-ranked cardiovascular impairments linked to an impaired glucose control.