Cardiac autonomic function and incident coronary heart disease: A population-based case-cohort study: The ARIC study

Duanping Liao, Jianwen Cai, Wayne D. Rosamond, Ralph W. Barnes, Richard G. Hutchinson, Eric A. Whitsel, Pentti Rautaharju, Gerardo Heiss

Research output: Contribution to journalArticle

276 Citations (Scopus)

Abstract

Cardiac autonomic activity, as assessed by heart rate variability, has been found to be associated with postmyocardial infarction mortality, sudden death, and all-cause mortality. However, the association of heart rate variability and the incidence of coronary heart disease (CHD) is not well described. The authors report on the association of baseline cardiac autonomic activity (1987-1989) with incident CHD after 3 years (1990-1992) of follow-up of the Atherosclerosis Risk in Communities Study cohort selected from four study centers in the United States by using a case-cohort design. The authors examined 137 incident cases of CHD and a stratified random sample of 2,252 examinees free of CHD at baseline. Baseline, supine, resting beat- to-beat heart rate data were collected. High- (0.16-0.35 Hz) and low- (0.025- 0.15 Hz) frequency spectral powers and high-/low-frequency power ratio, estimated from spectral analysis, and standard deviation of all normal R-R intervals, calculated from time domain analysis, were used as the conventional indices of cardiac parasympathetic, sympatho-parasympathetic, and their balance, respectively. Incident CHD was defined as hospitalized myocardial infarction, fatal CHD, or cardiac revascularization procedures during 3 years of follow-up. The age, race, gender, and other CHD risk factor-adjusted relative risks (and 95% confidence intervals) of incident CHD comparing the lowest quartiles with the upper three quartiles of high- frequency power, low-frequency power, high-/low-frequency power ratio, and standard deviation of R-R intervals were 1.72 (95% confidence interval (CI) 1.17-2.51), 1.09 (95% CI 0.72-1,64), 1.25 (95% CI 0.84-1.86), and 1.39 (95% CI 0.94-2.04), respectively. The findings from this population-based, prospective study suggest that altered cardiac autonomic activity, especially lower parasympathetic activity, is associated with the risk of developing CHD.

Original languageEnglish (US)
Pages (from-to)696-706
Number of pages11
JournalAmerican Journal of Epidemiology
Volume145
Issue number8
DOIs
StatePublished - Apr 15 1997

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Coronary Disease
Cohort Studies
Population
Confidence Intervals
Heart Rate
Mortality
Sudden Death
Infarction
Atherosclerosis
Myocardial Infarction
Prospective Studies
Incidence

All Science Journal Classification (ASJC) codes

  • Epidemiology

Cite this

Liao, Duanping ; Cai, Jianwen ; Rosamond, Wayne D. ; Barnes, Ralph W. ; Hutchinson, Richard G. ; Whitsel, Eric A. ; Rautaharju, Pentti ; Heiss, Gerardo. / Cardiac autonomic function and incident coronary heart disease : A population-based case-cohort study: The ARIC study. In: American Journal of Epidemiology. 1997 ; Vol. 145, No. 8. pp. 696-706.
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title = "Cardiac autonomic function and incident coronary heart disease: A population-based case-cohort study: The ARIC study",
abstract = "Cardiac autonomic activity, as assessed by heart rate variability, has been found to be associated with postmyocardial infarction mortality, sudden death, and all-cause mortality. However, the association of heart rate variability and the incidence of coronary heart disease (CHD) is not well described. The authors report on the association of baseline cardiac autonomic activity (1987-1989) with incident CHD after 3 years (1990-1992) of follow-up of the Atherosclerosis Risk in Communities Study cohort selected from four study centers in the United States by using a case-cohort design. The authors examined 137 incident cases of CHD and a stratified random sample of 2,252 examinees free of CHD at baseline. Baseline, supine, resting beat- to-beat heart rate data were collected. High- (0.16-0.35 Hz) and low- (0.025- 0.15 Hz) frequency spectral powers and high-/low-frequency power ratio, estimated from spectral analysis, and standard deviation of all normal R-R intervals, calculated from time domain analysis, were used as the conventional indices of cardiac parasympathetic, sympatho-parasympathetic, and their balance, respectively. Incident CHD was defined as hospitalized myocardial infarction, fatal CHD, or cardiac revascularization procedures during 3 years of follow-up. The age, race, gender, and other CHD risk factor-adjusted relative risks (and 95{\%} confidence intervals) of incident CHD comparing the lowest quartiles with the upper three quartiles of high- frequency power, low-frequency power, high-/low-frequency power ratio, and standard deviation of R-R intervals were 1.72 (95{\%} confidence interval (CI) 1.17-2.51), 1.09 (95{\%} CI 0.72-1,64), 1.25 (95{\%} CI 0.84-1.86), and 1.39 (95{\%} CI 0.94-2.04), respectively. The findings from this population-based, prospective study suggest that altered cardiac autonomic activity, especially lower parasympathetic activity, is associated with the risk of developing CHD.",
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Liao, D, Cai, J, Rosamond, WD, Barnes, RW, Hutchinson, RG, Whitsel, EA, Rautaharju, P & Heiss, G 1997, 'Cardiac autonomic function and incident coronary heart disease: A population-based case-cohort study: The ARIC study', American Journal of Epidemiology, vol. 145, no. 8, pp. 696-706. https://doi.org/10.1093/aje/145.8.696

Cardiac autonomic function and incident coronary heart disease : A population-based case-cohort study: The ARIC study. / Liao, Duanping; Cai, Jianwen; Rosamond, Wayne D.; Barnes, Ralph W.; Hutchinson, Richard G.; Whitsel, Eric A.; Rautaharju, Pentti; Heiss, Gerardo.

In: American Journal of Epidemiology, Vol. 145, No. 8, 15.04.1997, p. 696-706.

Research output: Contribution to journalArticle

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T1 - Cardiac autonomic function and incident coronary heart disease

T2 - A population-based case-cohort study: The ARIC study

AU - Liao, Duanping

AU - Cai, Jianwen

AU - Rosamond, Wayne D.

AU - Barnes, Ralph W.

AU - Hutchinson, Richard G.

AU - Whitsel, Eric A.

AU - Rautaharju, Pentti

AU - Heiss, Gerardo

PY - 1997/4/15

Y1 - 1997/4/15

N2 - Cardiac autonomic activity, as assessed by heart rate variability, has been found to be associated with postmyocardial infarction mortality, sudden death, and all-cause mortality. However, the association of heart rate variability and the incidence of coronary heart disease (CHD) is not well described. The authors report on the association of baseline cardiac autonomic activity (1987-1989) with incident CHD after 3 years (1990-1992) of follow-up of the Atherosclerosis Risk in Communities Study cohort selected from four study centers in the United States by using a case-cohort design. The authors examined 137 incident cases of CHD and a stratified random sample of 2,252 examinees free of CHD at baseline. Baseline, supine, resting beat- to-beat heart rate data were collected. High- (0.16-0.35 Hz) and low- (0.025- 0.15 Hz) frequency spectral powers and high-/low-frequency power ratio, estimated from spectral analysis, and standard deviation of all normal R-R intervals, calculated from time domain analysis, were used as the conventional indices of cardiac parasympathetic, sympatho-parasympathetic, and their balance, respectively. Incident CHD was defined as hospitalized myocardial infarction, fatal CHD, or cardiac revascularization procedures during 3 years of follow-up. The age, race, gender, and other CHD risk factor-adjusted relative risks (and 95% confidence intervals) of incident CHD comparing the lowest quartiles with the upper three quartiles of high- frequency power, low-frequency power, high-/low-frequency power ratio, and standard deviation of R-R intervals were 1.72 (95% confidence interval (CI) 1.17-2.51), 1.09 (95% CI 0.72-1,64), 1.25 (95% CI 0.84-1.86), and 1.39 (95% CI 0.94-2.04), respectively. The findings from this population-based, prospective study suggest that altered cardiac autonomic activity, especially lower parasympathetic activity, is associated with the risk of developing CHD.

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