Cardiovascular autonomic dysfunction is linked with arterial stiffness across glucose metabolism: the Maastricht study
Authors' conclusion
Cardiovascular autonomic dysfunction is associated with higher aortic and carotid stiffness, especially in people with dysglycemia.
Study context
- Population
- Participants of the Maastricht study; median age 60 years (53; 66), 51% women, 20% T2D by designPulse wave velocity (PWV) 3673
- Exposure
- Lower vs higher heart rate variability (HRV) in relation to arterial stiffness
- Outcome
- Aortic stiffness (carotid-femoral PWV) and carotid stiffness (carotid artery distensibility) per SD lower HRV z-score
Methodological detailspopulation-based cohort (Maastricht study), multiple linear regression, adjusted for demographic, lifestyle and cardiovascular risk factors, T2D oversampled by design
- Population-based cohort (Maastricht study)
- Multiple linear regression, adjusted for demographic, lifestyle and cardiovascular risk factors
- T2D oversampled by design
Main finding
As reported in the abstract
Arterial stiffness per SD lower HRV z-score
Higher PWV per SD lower time-domain HRV z-score
2.8%
95% CI 2.1% to 3.4%
Higher PWV per SD lower frequency-domain HRV z-score
2.8%
95% CI 2.1% to 3.5%
Lower CD per SD lower time-domain HRV
3.2%
95% CI 1.4% to 5.0%
Lower CD per SD lower frequency-domain HRV
3.1%
95% CI 1.2% to 5.0%
Observational data: associations, not effects.
Further findings
Effect modification by glucose metabolism status
- Associations of greater magnitude in prediabetes and T2D vs normal glucose metabolism; P for interaction (prediabetes vs normal)
- <0.01
- P for interaction (T2D vs normal glucose metabolism)
- <0.05 to <0.10
Original publication
Cardiovascular autonomic dysfunction is linked with arterial stiffness across glucose metabolism: the Maastricht study. BMJ Open Diabetes Res Care. Published 6 March 2026. doi:10.
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