Normative data on cardiovascular autonomic function in Greenlandic Inuit

Marie Mathilde Bjerg Christensen, Christian Stevns Hansen, Jesper Fleischer, Dorte Vistisen, Stine Byberg, Trine Larsen, Jens Christian Laursen, Marit Eika Jørgensen


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 piecewise linear quantile regression models at the fifth percentile. Models were adjusted for age and sex.

RESULTS: Based on examinations of 472 participants (61.7% females), normative reference data was established for all outcomes. Mean age was 54 years (SD 13.1). 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 or 70 years for supine-to-upright position ratio and low frequency power. However, the number of observations in subjects older than 60 or 70 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.

Original languageEnglish
Article numbere002121
JournalBMJ open diabetes research & care
Issue number1
Pages (from-to)1-10
Number of pages10
Publication statusPublished - Sept 2021


  • Aged
  • Autonomic Nervous System
  • Cross-Sectional Studies
  • Diabetic Neuropathies
  • Female
  • Heart Rate
  • Humans
  • Inuits
  • Male
  • Middle Aged


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