Comparative Evaluation of Baroreflex Sensitivity and Cardiovascular Autonomic Regulation in Type 2 Diabetes Mellitus and Healthy Individuals: A Cross-Sectional Study

Q: What are the key findings of this study?

Type 2 diabetes mellitus was associated with an approximately 50% lower resting baroreflex sensitivity compared with healthy controls (7.1 vs 14.2 ms/mmHg; MD 7.1, 95% CI 6.2-8.0; p<0.0001).

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Type 2 Diabetes Mellitus (T2DM) (n=120). Intervention: Type 2 Diabetes Mellitus (T2DM) vs. Healthy non-diabetic controls. Primary outcome: Resting Baroreflex Sensitivity (BRS, ms/mmHg) (MD 7.1 ms/mmHg, 95% CI 6.2-8.0, p=<0.0001).

Q: What does this research mean for the field?

Type 2 diabetes mellitus is associated with marked impairment of baroreflex sensitivity and cardiovascular autonomic regulation, with baroreflex sensitivity independently declining with higher HbA1c levels and longer diabetes duration. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To compare baroreflex sensitivity, cardiovascular autonomic reflex responses, resting hemodynamics, and frequency-domain heart rate variability between adults with type 2 diabetes and healthy controls.

Amir Usmani; Priyanka Mirdha; VijayKumar Gupta; Sunil Khare

doi:10.61336/jdme.0704.17

October 26, 2026Journal of Diabetes Metabolism and EndocrinologyOpen Access

Comparative Evaluation of Baroreflex Sensitivity and Cardiovascular Autonomic Regulation in Type 2 Diabetes Mellitus and Healthy Individuals: A Cross-Sectional Study

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Key result

Type 2 diabetes linked to ~50% lower resting baroreflex sensitivity compared with healthy controls.

MD −7.1 ms/mmHg
95% CI 6.2-8.0
P<0.0001
n=120

Why the study?

Type 2 Diabetes Mellitus (T2DM) may impair cardiovascular autonomic regulation, including arterial baroreflex function, cardiovagal responses, and orthostatic blood-pressure control, motivating a comparison of baroreflex sensitivity, autonomic reflex tests, resting hemodynamics, and heart rate variability between individuals with T2DM and healthy controls.

Key Points

To compare baroreflex sensitivity, cardiovascular autonomic reflex responses, resting hemodynamics, and frequency-domain heart rate variability between adults with type 2 diabetes and healthy controls.
Comparative cross-sectional study of 120 adults aged 45-55 years (60 with type 2 diabetes and 60 non-diabetic controls).
Evaluated resting, sequence-up, and sequence-down baroreflex sensitivity (BRS), baroreflex sequence counts, cardiovagal and vasomotor autonomic reflex tests, and spectral heart rate variability (HRV).
Resting BRS was lower in type 2 diabetes than in controls (7.1±1.9 vs 14.2±2.8 ms/mmHg; difference 7.1, 95% CI 6.2-8.0; p<0.0001), alongside reduced sequence-up (7.8±2.2 vs 15.8±3.1) and sequence-down BRS (6.5±1.8 vs 13.1±2.6 ms/mmHg).
Cardiovagal reflex responses were attenuated and postural systolic blood-pressure fall was greater in diabetes (14.8±4.6 vs 4.2±2.1 mmHg; p<0.0001), accompanied by reduced total HRV power (1120.4±285.6 vs 2145.6±412.3 ms²; p<0.0001).
Among individuals with diabetes, resting BRS correlated inversely with HbA1c (r = −0.724, 95% CI −0.812 to −0.608; p<0.0001) and diabetes duration (r = −0.681, 95% CI −0.780 to −0.553; p<0.0001).

Study Design

Type

Cross-Sectional (n=120)

Multicenter

No

Structured PICO

P

Population

120 Indian adults aged 45-55 years (mean age 49.75 years), comprising 60 patients with clinically stable type 2 diabetes mellitus (≥1 year duration) and 60 age-matched healthy non-diabetic controls evaluated in a cross-sectional study.

C

Comparator

60 age-matched apparently healthy non-diabetic controls with normal clinical and biochemical glycemic assessment and no recognized cardiovascular autonomic disorder, selected from hospital staff, patient attendants, and community volunteers.

O

Outcome

Resting Baroreflex Sensitivity (BRS), sequence-up BRS, sequence-down BRS (expressed in ms/mmHg), and total baroreflex sequence countsurrogate

Main Result

Mean Difference: 7.1 (95% CI 6.2–8)

Absolute Event Rate: 7.1% vs 14.2%

p-value: p=<0.0001

Middle-aged adults with Type 2 Diabetes Mellitus exhibit approximately 50% lower resting baroreflex sensitivity alongside broader cardiovagal, vasomotor, and heart rate variability impairments compared to healthy controls, with worse autonomic function independently linked to higher HbA1c and longer disease duration.

Limitations

Single-center cross-sectional design limits causal interpretation and generalizability
Potential confounding from group differences in BMI, resting blood pressure, treatment exposure, physical fitness, vascular stiffness, and unmeasured comorbidities
Lack of standardized reporting details for beat-to-beat blood-pressure acquisition, synchronized ECG recording, BRS sequence algorithm, and spectral HRV processing
Participant-level diagnostic classification of cardiac autonomic neuropathy (CAN) and orthostatic hypotension was not established by group summary measures
Differences in BMI, resting blood pressure, treatment exposure, physical fitness, vascular stiffness, and unmeasured comorbidities may have contributed to group contrasts
Standardization and reporting of the original beat-to-beat blood-pressure acquisition, synchronized ECG recording, BRS sequence algorithm, and spectral HRV processing are necessary for reproducibility and comparison with other studies
Participant-level diagnostic classification of cardiovascular autonomic neuropathy (CAN) and orthostatic hypotension was not established by the group summary measures

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Implication

T2DM-linked BRS reduction may flag autonomic risk; leaves open whether it predicts events or responds to glycemic control.

Abstract

Type 2 Diabetes Mellitus (T2DM) may impair cardiovascular autonomic regulation, including arterial baroreflex function, cardiovagal responses and orthostatic blood-pressure control. Objective: To compare Baroreflex Sensitivity (BRS), cardiovascular autonomic reflex tests, resting hemodynamics and frequency-domain Heart Rate Variability (HRV) in individuals with T2DM and healthy non-diabetic controls. Methods: This comparative cross-sectional study included 120 adults aged 45-55 years (60 with T2DM and 60 non-diabetic controls). The assessed outcomes comprised resting, sequence-up and sequence-down BRS, baroreflex sequence count, cardiovagal and vasomotor reflex tests, resting cardiovascular indices and spectral HRV. Associations between BRS and clinical variables were examined within the diabetic group. Results: Resting BRS was lower in participants with T2DM than in controls (7.1±1.9 versus 14.2±2.8 ms/mmHg; p<0.0001). Sequence-up BRS (7.8±2.2 versus 15.8±3.1) and sequence-down BRS (6.5±1.8 versus 13.1±2.6 ms/mmHg) were similarly reduced. Deep-breathing E:I ratio, standing 30:15 ratio, Valsalva ratio and respiratory heart-rate variation were lower in T2DM, whereas postural systolic blood-pressure fall was greater (14.8±4.6 versus 4.2±2.1 mmHg). Total HRV power and high-frequency power were reduced. In T2DM, BRS correlated inversely with HbA1c (r = −0.724) and diabetes duration (r = −0.681), both p<0.0001. Conclusion: T2DM was associated with diminished baroreflex responsiveness, attenuated cardiovagal reflexes, impaired orthostatic compensation and reduced HRV. Higher HbA1c and longer diabetes duration were associated with lower BRS.

Discussion

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Cite This Study

Usmani et al. (2026) conducted a cross-sectional in Type 2 Diabetes Mellitus (T2DM) (n=120). Type 2 Diabetes Mellitus (T2DM) vs. Healthy non-diabetic controls was evaluated on Resting Baroreflex Sensitivity (BRS, ms/mmHg) (MD 7.1 ms/mmHg, 95% CI 6.2-8.0, p=<0.0001). Type 2 diabetes mellitus was associated with an approximately 50% lower resting baroreflex sensitivity compared with healthy controls (7.1 vs 14.2 ms/mmHg; MD 7.1, 95% CI 6.2-8.0; p<0.0001).

synapsesocial.com/papers/6aebc8ba3e63ca1b6c315e13 https://doi.org/10.61336/jdme.0704.17

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Comparative Evaluation of Baroreflex Sensitivity and Cardiovascular Autonomic Regulation in Type 2 Diabetes Mellitus and Healthy Individuals: A Cross-Sectional Study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Comparative Evaluation of Baroreflex Sensitivity and Cardiovascular Autonomic Regulation in Type 2 Diabetes Mellitus and Healthy Individuals: A Cross-Sectional Study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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