Non-dipping heart rate, microalbuminuria and thrombocytosis in type 2 diabetes mellitus: Can we connect the dots?

摘要

Many studies have shown a significant association between heart rate (HR) and cardiovascular (CV) and all-cause mortality in the general population and individuals with various diseases [1-3]. Described by simple numbers, HR and blood pressure (BP) are in fact determined by a complex interplay of sympathetic and parasympa-thetic components of the autonomic nervous system (ANS) on the cardiac electrical system, baroreceptors, vascular tone, endothelial function and cardiac contractility in response to different stimuli in physiological and pathological conditions. Many abnormalities of HR and BP are observed in diabetes mellitus (DM), whether type 1 or type 2 (T2DM), due to its propensity to cause cardiac autonomic neuropathy (CAN). Given the complex problem of CAN, the CAN Subcommittee of the Toronto Consensus Panel on Diabetic Neuropathy has published a consensus document which discusses epidemiology, guidelines on definitions and staging, standardization of diagnostic criteria, and therapeutic approach, etc.