Resting heart rate and the risk of microvascular complications in patients with type 2 diabetes mellitus.

A higher resting heart rate is associated with an increased probability of cardiovascular complications and premature death in patients with type 2 diabetes mellitus. the impact of heart rate on the risk of developing microvascular complications,such as diabetic retinopathy and nephropathy,is,however,unknown. the present study tests the hypothesis that a higher resting heart rate is associated with an increased incidence and a greater progression of microvascular complications in patients with type 2 diabetes mellitus. the relation between baseline resting heart rate and the development of a major microvascular event was examined in 11 140 patients who participated in the action in diabetes and vascular disease: preterax and diamicron modified release controlled evaluation (advance) study. major microvascular events were defined as a composite of new or worsening nephropathy or new or worsening retinopathy. patients with a higher baseline heart rate were at increased risk of a new major microvascular complication during follow-up (adjusted hazard ratio: 1.13 per 10 beats per minute; 95% confidence interval: 1.07-1.20; p<0.001). the excess hazard was evident for both nephropathy (adjusted hazard ratio: 1.16 per 10 beats per minute; 95% confidence interval: 1.08-1.25) and retinopathy (adjusted hazard ratio: 1.11 per 10 beats per minute; 95% confidence interval: 1.02-1.21). patients with type 2 diabetes mellitus who have a higher resting heart rate experience a greater incidence of new-onset or progressive nephropathy and retinopathy. url: http://www.clinicaltrials.gov. unique identifier: nct00145925. http://www.advance-trial.com/static/html/prehome/prehome.asp.