To evaluate the effect of coronary artery disease on parasympathetic cardiac reflexes in patients with noninsulin- dependent diabetes mellitus (NIDDM), we studied standard cardiovascular reflexes in 27 NIDDM patients with coronary artery disease (group 1) and in 21 NIDDM patients with no signs of coronary artery disease (group 2). Groups did not differ with respect to age, duration of diabetes, or presence of retinopathy. The mean ± SD heart-rate variation in deep breathing was lower in group 1 than in group 2 (11.6 ± 6.5 vs. 17.1 ± 9.0 beats/min, P < 0.05). Heart-rate variation was more often abnormally low (<10 beats/min) in group 1 than in group 2 (48 vs. 19%, P < 0.05). Thus, the presence of coronary artery disease appears to modify cardiac parasympathetic reflexes in patients with diabetes mellitus and must be kept in mind when interpreting test results.

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