Impaired postexercise cardiovascular autonomic modulation in middle-aged women with type 2 diabetes.

BACKGROUND: Type 2 diabetes is associated with cardiovascular autonomic dysfunction. Postexercise autonomic modulation may be different in obese individuals with and without type 2 diabetes. We examined postexercise responses in nondiabetic and diabetic women aged 40-60 years.

METHODS: Hemodynamics, high-frequency and low-frequency of RR interval, low-frequency of systolic blood pressure variability and baroreflex sensitivity were evaluated before and after a 20 min walk at approximately 65% of VO2 peak in eight lean, 12 obese without type 2 diabetes and eight women with type 2 diabetes. Postexercise measurements were obtained at 10-15, 20-25 and 30-35 min.

RESULTS: Systolic blood pressure decreased at 10 (P<0.001) and 20 min (P<0.01) in all groups. Total peripheral resistance decreased at 10 min in all women, but the subsequent increase at 20 min was greater (P<0.01) in lean than in diabetic women. Log-transformed low-frequency of systolic blood pressure increased (P<0.01) at 10 and 20 min in all women, but the increase at 10 min was smaller (P<0.05) in diabetic than in lean women. Heart rate was increased (P<0.001) at 10 min in all women and at 20 min in both obese groups. Both log-transformed high-frequency of RR interval and baroreflex sensitivity decreased at 10 and 20 min of recovery in all groups. A group-by-time interaction (P<0.05) was observed for heart rate and baroreflex sensitivity as a lower heart rate and higher baroreflex sensitivity were observed in lean women than in women with type 2 diabetes.

CONCLUSIONS: Reduced postexercise baroreflex sensitivity and responses to autonomic cardiovascular activity contribute to an attenuated recovery of heart rate and total peripheral resistance after brisk walking in middle-aged obese women with type 2 diabetes.