Heart rate elevation and diabetic retinopathy in patients with type 2 diabetes mellitus and normoalbuminuria

To investigate the role of heart rate (HR) and blood pressure (BP) for diab etic retinopathy, 24-h ambulatory HR and BP were monitored for 162 in patie nts with type 2 diabetes and normoalbuminuria. The fundus was assessed as n o retinopathy, simple diabetic retinopathy (SDR) and proliferative retinopa thy (PDR). Comparing the highest with the lowest quartile of diabetic durat ion, the relative risk for retinopathy was 9.3 and for nocturnal HR, it was 3.6. Comparison among three retinopathy groups (no retinopathy, group 1, n = 122; SDR, group 2, n = 24; Pre-PDR or PDR, group 3, n = 16) showed that 24-h and nocturnal HR were significantly higher in group 3 (80 +/- 9 and 71 +/- 9 beats per min) than in group 2 (73 +/- 18 and 64 +/- 18) and group 1 (72 +/- 7 and 60 +/- 7). In multiple logistic analysis, the odds ratio of diabetic duration and nocturnal HR to the existence of retinopathy was 1.17 (95% CI, 1.10-1.25, P = 0.00001) and 1.11 (95% CI, 1.05-1.17, P = 0.0002). We concluded that diabetic retinopathy is related to diabetic duration and high heart rate in type 2 diabetes mellitus with normoalbuminuria. Heart r ate elevation may be a predictor of advanced retinopathy. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.