E-ISSN 2231-3206 | ISSN 2320-4672
 

Original Research 


Rate pressure product predicts cardiovascular risk in type 2 diabetics with cardiac autonomic neuropathy

Rishu Segan, Vidushi Gupta, Lily Walia, Naveen Mittal.

Cited by (4)

Abstract
Background: Unexplained sudden deaths due cardiac involvement are linked to autonomic neuropathy in diabetics but mechanisms remain unclear. Heart rate and pulse pressure etc have been used to predict cardiovascular risk. But the association of Rate Pressure Product remains unascertained.

Objective: To predict cardiovascular risk in type 2 diabetic patients with cardiac autonomic neuropathy using a non-invasive indicator, rate pressure product.

Materials and Methods: Case control study done on two groups of 20 each, age matched type 2 diabetics with/without cardiac autonomic neuropathy and matched with 20 controls of either sex (n=60). Rate Pressure Product was measured in response to cold pressor and hand grip test. Statistical analysis was done using SPSS software by paired and unpaired t test.

Results: There was a significant increase in rate pressure product in controls and in patients without autonomic neuropathy after the tests (p<0.001). Patients with autonomic neuropathy had non-significant increase in rate pressure product (p>0.001). The change in RPP (ΔRPP) was least in diabetics with autonomic neuropathy and significant in controls and non-neuropathy diabetics using unpaired t-test ( p< 0.05 ). Resting RPP was recorded highest in diabetic autonomic neuropathy patients.
Conclusion: Heightened resting RPP and failure of Rate Pressure Product increment during cardiac sympathetic stimulation promotes aggravated ischemic episodes. This renders autonomic neuropathy diabetics vulnerable to adverse cardiovascular events leading to increased morbidity and mortality.

Key words: Rate Pressure Product, Autonomic neuropathy, Diabetes Mellitus


 
ARTICLE TOOLS
Abstract
PDF Fulltext
Print this article Print this Article
How to cite this articleHow to cite this article
Export to
Export to
Related Records
 Articles by Rishu Segan
Articles by Vidushi Gupta
Articles by Lily Walia
Articles by Naveen Mittal
on Google
on Google Scholar
Article Statistics
 Viewed: 5575
Downloaded: 1471
Cited: 4

REFERENCES
1. Mathur CP, Gupta D. QTc prolongation in Diabetes Mellitus – An indicator of cardiac autonomic neuropathy. J Indian Academy of Clin Med 2006;7:130-132.


2. Nagpal S, Walia L, Lata H, Sood N, Ahuja G K. Effect of exercise on Rate Pressure Product in premenopausal and postmenopausal women with coronary artery disease. Indian J PhysiolPharmacol 2007;51:279 – 283.

[
Pubmed]   

3. Jouven X, Zureik M, Desnos M, Guérot C, Ducimetière P. Resting heart rate as a predictive risk factor for sudden death in middle-aged men. Cardiovasc Res. 2001 May;50(2):373-378.

http://dx.doi.org/10.1016/S0008-6363(01)00230-9


4. Cockcroft JR, Wilkinson IB, Evans M, McEwan P, Peters JR, Davies S, Scanlon MF, Currie CJ. Pulse pressure predicts cardiovascular risk in patients with type 2 diabetes mellitus. Am J Hypertens. 2005 Nov;18(11):1463-1467.

http://dx.doi.org/10.1016/j.amjhyper.2005.05.009

[
Pubmed]   

5. Lowery D, Fillingim RB, Wright RA. Sex differences and incentive effects on perceptual and cardiovascular responses to cold pressor pain. Psychosom Med 2003;65:284-291.

http://dx.doi.org/10.1097/01.PSY.0000033127.11561.78

[
Pubmed]   

6. Brownlee M., Lloyd A.P., Cooper M.E. et al, (2008). Complications of diabetes mellitus, in Williams textbook of Endocrinology Kronenberg H.M., Melmed S., Polonsky K. S., Larsen P.R. eds, Philadelphia, saunders.1473-1474.


7. Reiser MF, Ferris Jr EB. The nature of the cold pressor test and its significance in relation to neurogenic and humoral mechanisms in hypertension. J Clin Invest 1948;27:156–163.

http://dx.doi.org/10.1172/JCI101919

[
Pubmed]    [PMC Free Fulltext]   

8. Walia L, Ahuja GK. Effect of cold pressor test on visual reaction time and auditory reaction time. Indian J of ExpBiol 2000;38:831-833.

[
Pubmed]   

9. Di Carli MF, Janisse J, Grunberger G, Ager J. Role of chronic hyperglycemia in the pathogenesis of coronary microvascular dysfunction in diabetes. J Am CollCardiol 2003;41:1387- 1393.

http://dx.doi.org/10.1016/S0735-1097(03)00166-9


10. Brownlee M, Lloyd AP, Cooper ME, Vinik AI, Nesto RW, Boulton AJM. Complications of Diabetes Mellitus. In : Kronenberg HM, Melmed S, Polonsky KS, Larsen PR (eds.) Williams textbook of Endocrinology, 11th Edn. : Saunders, Philadelphia 2008;pp.1466.


11. Vijayalakshmi P, Mohan M, Bhavanani AB, Patil A, Kumar BP. Modulation of stress induced by isometric hand grip test in hypertensive patients following yogic relaxation training. Indian J PhysiolPharmacol 2004;48:59-64.

[
Pubmed]   

12. Siegelova J, Fisher B, Dusek J, Placheta Z, Cornelissen G, Halberg F. Circadian variability of rate – pressure product in essential hypertension with enalapril therapy. Scr Med (Brno) 2000;73:67-75.


13. Mohan M, Kaviraja, Bhavanani A, Vijayalakshmi P, Surendiran A. Effect of slow and fast pranayamas on reactiontime and cardiorespiratory variables. Indian J PhysiolPharmacol 2005;49:313-318.


14. Khoshdel AR, Carney SL, White S. Disturbed hemodynamic cardiac exercise stress test response in non smoking, normolipidemic, normotensive, diabetic subjects. Diab Res ClinPract 2007;75:193-199.

http://dx.doi.org/10.1016/j.diabres.2006.06.016

[
Pubmed]   

15. Foo K, Sekhri N, Knight C, Deaner A, Cooper J, Ranjadayalan K, et al. The effect of diabetes on heart rate and other determinants of myocardial oxygen demand in acute coronary syndromes. Diabet Med. 2004;21(9):1025-1031.

http://dx.doi.org/10.1111/j.1464-5491.2004.01413.x

[
Pubmed]   

16. Forjaz CL, Matsudaira Y, Rodrigues FB, Nunes N, Negrão CE. Post-exercise changes in blood pressure, heart rate and rate pressure product at different exercise intensities in normotensive humans. Braz J Med Biol Res 1998;31:1247-1255.

http://dx.doi.org/10.1590/S0100-879X1998001000003

[
Pubmed]   

This Article Cited By the following articles

Effect of esmolol infusion on myocardial oxygen consumption during extubation and quality of recovery in elderly patients undergoing general anesthesia: randomized, double blinded, clinical trial
Egyptian Journal of Anaesthesia 2015; (): .

1
 
Dopamine D2R Agonist-Induced Cardiovascular Effects in Healthy Male Subjects: Potential Implications in Clinical Settings
ISRN Neurology 2014; 2014(): 1.

2
 
Prescription of Generic Drugs
National Journal of Physiology, Pharmacy and Pharmacology 2013; 3(1): 1.

3
 
Trends of articles published in National Journal of Physiology, Pharmacy and Pharmacology NJPPP
National Journal of Physiology, Pharmacy and Pharmacology 2013; 3(2): 102.

4
 

How to Cite this Article
Pubmed Style

Segan R, Gupta V, Walia L, Mittal N. Rate pressure product predicts cardiovascular risk in type 2 diabetics with cardiac autonomic neuropathy. Natl J Physiol Pharm Pharmacol. 2013; 3(1): 43-47. doi:10.5455/njppp.2013.3.43-47


Web Style

Segan R, Gupta V, Walia L, Mittal N. Rate pressure product predicts cardiovascular risk in type 2 diabetics with cardiac autonomic neuropathy. http://www.njppp.com/?mno=24143 [Access: September 19, 2018]. doi:10.5455/njppp.2013.3.43-47


AMA (American Medical Association) Style

Segan R, Gupta V, Walia L, Mittal N. Rate pressure product predicts cardiovascular risk in type 2 diabetics with cardiac autonomic neuropathy. Natl J Physiol Pharm Pharmacol. 2013; 3(1): 43-47. doi:10.5455/njppp.2013.3.43-47



Vancouver/ICMJE Style

Segan R, Gupta V, Walia L, Mittal N. Rate pressure product predicts cardiovascular risk in type 2 diabetics with cardiac autonomic neuropathy. Natl J Physiol Pharm Pharmacol. (2013), [cited September 19, 2018]; 3(1): 43-47. doi:10.5455/njppp.2013.3.43-47



Harvard Style

Segan, R., Gupta, V., Walia, L. & Mittal, N. (2013) Rate pressure product predicts cardiovascular risk in type 2 diabetics with cardiac autonomic neuropathy. Natl J Physiol Pharm Pharmacol, 3 (1), 43-47. doi:10.5455/njppp.2013.3.43-47



Turabian Style

Segan, Rishu, Vidushi Gupta, Lily Walia, and Naveen Mittal. 2013. Rate pressure product predicts cardiovascular risk in type 2 diabetics with cardiac autonomic neuropathy. National Journal of Physiology, Pharmacy and Pharmacology, 3 (1), 43-47. doi:10.5455/njppp.2013.3.43-47



Chicago Style

Segan, Rishu, Vidushi Gupta, Lily Walia, and Naveen Mittal. "Rate pressure product predicts cardiovascular risk in type 2 diabetics with cardiac autonomic neuropathy." National Journal of Physiology, Pharmacy and Pharmacology 3 (2013), 43-47. doi:10.5455/njppp.2013.3.43-47



MLA (The Modern Language Association) Style

Segan, Rishu, Vidushi Gupta, Lily Walia, and Naveen Mittal. "Rate pressure product predicts cardiovascular risk in type 2 diabetics with cardiac autonomic neuropathy." National Journal of Physiology, Pharmacy and Pharmacology 3.1 (2013), 43-47. Print. doi:10.5455/njppp.2013.3.43-47



APA (American Psychological Association) Style

Segan, R., Gupta, V., Walia, L. & Mittal, N. (2013) Rate pressure product predicts cardiovascular risk in type 2 diabetics with cardiac autonomic neuropathy. National Journal of Physiology, Pharmacy and Pharmacology, 3 (1), 43-47. doi:10.5455/njppp.2013.3.43-47





Most Viewed Articles
  • Applications of computer science in Pharmacy: An overview
    Shivraj Popat Jadhav, Komal Nikam, Anand Gandhi, Kishor Salunkhe, Narendra Shinde.
    Natl J Physiol Pharm Pharmacol. 2012; 2(1): 1-9
    » Abstract

  • How to calculate sample size in animal studies?
    Hitesh Shah
    Natl J Physiol Pharm Pharmacol. 2011; 1(1): 35-39
    » Abstract

  • Chlorhexidine:The gold standard in chemical plaque control [English]
    Setu mathur, Tanu mathur,Rahul shrivastava, Rohit khatri
    Natl J Physiol Pharm Pharmacol. 2011; 1(2): 45-50
    » Abstract

  • Assessment of Nutritional Status of Pregnant Women Attending the City Tebessa PMI (Algeria) [English]
    Taleb Salima, Kaibi Mounira, Deghboudj Nadjia
    Natl J Physiol Pharm Pharmacol. 2011; 1(2): 97-105
    » Abstract

  • Analyzing Pharmaceutical Industry [English]
    Veselin Tima Dickov, Dragan Mitrovic, Boris Milan Kuzman
    Natl J Physiol Pharm Pharmacol. 2011; 1(1): 1-8
    » Abstract & References » doi: 10.5455/njppp.2011.1.1-8

  • Difference in pulmonary function test among the athletic and sedentary population
    ShobhaRani Vedala, Niranjan Paul, Abhay B Mane
    Natl J Physiol Pharm Pharmacol. 2013; 3(2): 118-123
    » Abstract & References » doi: 10.5455/njppp.2013.3.109-114

  • Antidiabetic activity of alcoholic extract of Neem (Azadirachta Indica) root bark
    Prabhakar Patil, Sudha Patil, Abhay Mane, Sushilkumar Verma
    Natl J Physiol Pharm Pharmacol. 2013; 3(2): 142-146
    » Abstract & References » doi: 10.5455/njppp.2013.3.134-138

  • Second MBBS medical student’s feedback on teaching methodology and evaluation methods in Pharmacology
    Nilesh Chavda, Preeti Yadav, Jay Karan, N. D. Kantharia
    Natl J Physiol Pharm Pharmacol. 2011; 1(1): 23-31
    » Abstract & References » doi: 10.5455/njppp.2011.1.23-31

  • Prophylaxis and Treatment for Leptospirosis: Where are the Evidences?
    Jaykaran Charan, Deepak Saxena, Summaiya Mulla
    Natl J Physiol Pharm Pharmacol. 2012; 2(2): 78-83
    » Abstract & References » doi: 10.5455/njppp.2012.2.78-83

  • How to write a thesis? [English]
    Swapnil s Agarwal, Preeti Yadav, Krishnadutt Chavali, Lavlesh Kumar
    Natl J Physiol Pharm Pharmacol. 2011; 1(2): 86-90
    » Abstract

  • Most Downloaded
  • How to calculate sample size in animal studies?
    Hitesh Shah
    Natl J Physiol Pharm Pharmacol. 2011; 1(1): 35-39
    » Abstract

  • Chlorhexidine:The gold standard in chemical plaque control [English]
    Setu mathur, Tanu mathur,Rahul shrivastava, Rohit khatri
    Natl J Physiol Pharm Pharmacol. 2011; 1(2): 45-50
    » Abstract

  • Applications of computer science in Pharmacy: An overview
    Shivraj Popat Jadhav, Komal Nikam, Anand Gandhi, Kishor Salunkhe, Narendra Shinde.
    Natl J Physiol Pharm Pharmacol. 2012; 2(1): 1-9
    » Abstract

  • Difference in pulmonary function test among the athletic and sedentary population
    ShobhaRani Vedala, Niranjan Paul, Abhay B Mane
    Natl J Physiol Pharm Pharmacol. 2013; 3(2): 118-123
    » Abstract & References » doi: 10.5455/njppp.2013.3.109-114

  • Analyzing Pharmaceutical Industry [English]
    Veselin Tima Dickov, Dragan Mitrovic, Boris Milan Kuzman
    Natl J Physiol Pharm Pharmacol. 2011; 1(1): 1-8
    » Abstract & References » doi: 10.5455/njppp.2011.1.1-8

  • Prophylaxis and Treatment for Leptospirosis: Where are the Evidences?
    Jaykaran Charan, Deepak Saxena, Summaiya Mulla
    Natl J Physiol Pharm Pharmacol. 2012; 2(2): 78-83
    » Abstract & References » doi: 10.5455/njppp.2012.2.78-83

  • Second MBBS medical student’s feedback on teaching methodology and evaluation methods in Pharmacology
    Nilesh Chavda, Preeti Yadav, Jay Karan, N. D. Kantharia
    Natl J Physiol Pharm Pharmacol. 2011; 1(1): 23-31
    » Abstract & References » doi: 10.5455/njppp.2011.1.23-31

  • A study of oxidative stress in gentamicin induced nephrotoxicity and effect of antioxidant vitamin C in Wistar rats.
    Chetankumar R. Acharya, Hetal N. Thakar, S. K. Vajpeyee
    Natl J Physiol Pharm Pharmacol. 2013; 3(1): 14-20
    » Abstract & References » doi: 10.5455/njppp.2013.3.14-20

  • Antidiabetic activity of alcoholic extract of Neem (Azadirachta Indica) root bark
    Prabhakar Patil, Sudha Patil, Abhay Mane, Sushilkumar Verma
    Natl J Physiol Pharm Pharmacol. 2013; 3(2): 142-146
    » Abstract & References » doi: 10.5455/njppp.2013.3.134-138

  • Assessment of Nutritional Status of Pregnant Women Attending the City Tebessa PMI (Algeria) [English]
    Taleb Salima, Kaibi Mounira, Deghboudj Nadjia
    Natl J Physiol Pharm Pharmacol. 2011; 1(2): 97-105
    » Abstract

  • Most Cited Articles
  • A study of oxidative stress in gentamicin induced nephrotoxicity and effect of antioxidant vitamin C in Wistar rats.
    Chetankumar R. Acharya, Hetal N. Thakar, S. K. Vajpeyee
    Natl J Physiol Pharm Pharmacol. 2013; 3(1): 14-20
    » Abstract & References » doi: 10.5455/njppp.2013.3.14-20
    Cited : 8 times [Click to see citing articles]

  • A pilot study to evaluate the effect of HAART on gonadal dysfunction in male HIV patients
    Abhishek Pathak, Lalit Prashant Meena, Jaya Chakravarty, Madhukar Rai, Shyam Sundar
    Natl J Physiol Pharm Pharmacol. 2015; 5(1): 33-35
    » Abstract & References » doi: 10.5455/njppp.2015.5.120720142
    Cited : 6 times [Click to see citing articles]

  • Quercetin improved spatial memory dysfunctions in rat model of intracerebroventricular streptozotocin-induced sporadic Alzheimer’s disease
    Manouchehr Ashrafpour, Sahar Parsaei, Hamid Sepehri
    Natl J Physiol Pharm Pharmacol. 2015; 5(5): 411-415
    » Abstract & References » doi: 10.5455/njppp.2015.5.2308201563
    Cited : 6 times [Click to see citing articles]

  • Newer anti-platelet and anti-thrombotic drugs on the horizon
    Ajai Garg, Anjana Pandey, Pranab Oza, Mridul Chaturvedi
    Natl J Physiol Pharm Pharmacol. 2013; 3(2): 105-110
    » Abstract & References » doi: 10.5455/njppp.2013.3.090420131
    Cited : 5 times [Click to see citing articles]

  • Rate pressure product predicts cardiovascular risk in type 2 diabetics with cardiac autonomic neuropathy
    Rishu Segan, Vidushi Gupta, Lily Walia, Naveen Mittal
    Natl J Physiol Pharm Pharmacol. 2013; 3(1): 43-47
    » Abstract & References » doi: 10.5455/njppp.2013.3.43-47
    Cited : 4 times [Click to see citing articles]

  • Effects of sixteen weeks exercise training on left ventricular dimensions and function in young athletes
    Sandip M Hulke, Yuganti P Vaidya, Amandeepkour R Ratta
    Natl J Physiol Pharm Pharmacol. 2012; 2(2): 152-158
    » Abstract & References » doi: 10.5455/njppp.2012.2.152-158
    Cited : 4 times [Click to see citing articles]

  • Antidiabetic activity of alcoholic extract of Neem (Azadirachta Indica) root bark
    Prabhakar Patil, Sudha Patil, Abhay Mane, Sushilkumar Verma
    Natl J Physiol Pharm Pharmacol. 2013; 3(2): 142-146
    » Abstract & References » doi: 10.5455/njppp.2013.3.134-138
    Cited : 4 times [Click to see citing articles]

  • Difference in pulmonary function test among the athletic and sedentary population
    ShobhaRani Vedala, Niranjan Paul, Abhay B Mane
    Natl J Physiol Pharm Pharmacol. 2013; 3(2): 118-123
    » Abstract & References » doi: 10.5455/njppp.2013.3.109-114
    Cited : 4 times [Click to see citing articles]

  • Prevalence and risk factors for eating disorders in Indian adolescent females
    Amit A Upadhyah, Rajesh Misra, Deepak N Parchwani, Pankaj B Maheria
    Natl J Physiol Pharm Pharmacol. 2014; 4(2): 153-157
    » Abstract & References » doi: 10.5455/njppp.2014.4.041220131
    Cited : 4 times [Click to see citing articles]

  • Time domain measures of heart rate variability during acute mental stress in Type 2 diabetics- A case control study
    Anupama Deepak, Deepak A N, Shobha Nallulwar, Vitthal Khode
    Natl J Physiol Pharm Pharmacol. 2014; 4(1): 34-38
    » Abstract & References » doi: 10.5455/njppp.2014.4.080720131
    Cited : 4 times [Click to see citing articles]