Normative data on cardiovascular autonomic function in Greenlandic Inuit

Introduction Diabetes is increasing among Greenlandic Inuit; however, the prevalence of cardiovascular autonomic neuropathy (CAN) is yet unknown. The assessment of CAN requires an ability to differentiate between normal and abnormal. The aim was to establish normative reference data of cardiovascular autonomic function in Greenlandic Inuit. Research design and methods In this cross- sectional study, cardiovascular autonomic function was evaluated in participants without diabetes during the Greenlandic Population Study 2018 and in the town Qasigiannguit in 2020. Assessment included cardiovascular autonomic reflex tests (CARTs) and power spectral analysis of heart rate variability (HRV). Normative reference limits were estimated by applying quantile regression models at the lowest fifth percentile, with age as the exposure variable and adjusted for sex. HRV models were additionally adjusted for resting heart rate. Results Based on examinations of 383 participants (60.6% females), normative reference data was established for all outcomes. Mean age was 52 years (SD 12.9). Higher age was inversely associated with all outcomes of CARTs and HRV. A linear fall in cardiovascular autonomic function tended to level off beyond age of 60 years for supine- to- upright position ratio. However, the number of observations in subjects older than 60 years was limited, which may have caused a flattening of the curve around that age. No other associations were found. Conclusions The general level of the CARTs and HRV for all age groups is notably lower than in previous studies from other nationalities. We speculate that sociodemographic and cultural aspects of the Greenlandic Inuit population including body mass index, smoking, physical activity and alcohol consumption may have affected the cardiovascular autonomic function.