Hypertension, Blood Pressure, and Heart Rate Variability

The Atherosclerosis Risk in Communities (ARIC) Study

Emily B. Schroeder, Duanping Liao, Lloyd E. Chambless, Ronald J. Prineas, Gregory W. Evans, Gerardo Heiss

Research output: Contribution to journalArticle

204 Citations (Scopus)

Abstract

Dysregulation of the autonomic nervous system has been implicated in the development of hypertension. Heart rate variability is a noninvasive tool to quantitatively estimate cardiac autonomic activity and has been used to document decreased cardiac autonomic activity in hypertension. The ability of decreased heart rate variability to predict incident hypertension has not been well studied, and there are no studies of whether hypertension leads to changes in heart rate variability. We investigated the temporal sequence linking hypertension, blood pressure, and heart rate variability in a population-based cohort of 11 061 individuals aged 45 to 54 years at baseline. Individuals with hypertension had decreased heart rate variability at baseline, and this association was present across the full blood pressure range. Among 7099 individuals without hypertension at baseline, low heart rate variability predicted greater risk of incident hypertension over 9 years of follow-up. The hazard ratio (95% confidence interval [CI]) for the lowest compared with the highest quartile of the standard deviation of normal-to-normal R-R intervals was 1.24 (95% CI, 1.10-1.40), for the root mean square of successive differences in normal-to-normal R-R intervals was 1.36 (95% CI, 1.21-1.54), and for R-R interval was 1.44 (95% CI, 1.27-1.63). Over 9 years, there was no measurable difference in the rate of change in heart rate variability among those with and without hypertension, although the differences in heart rate variability at follow-up were smaller than those at baseline. These findings thus support the thesis that the autonomic nervous system is involved in the development of hypertension, yet suggest that differences in the autonomic profile of hypertensives and normotensives do not increase with time.

Original languageEnglish (US)
Pages (from-to)1106-1111
Number of pages6
JournalHypertension
Volume42
Issue number6
DOIs
StatePublished - Dec 1 2003

Fingerprint

Atherosclerosis
Heart Rate
Blood Pressure
Hypertension
Confidence Intervals
Autonomic Nervous System
Population

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Schroeder, Emily B. ; Liao, Duanping ; Chambless, Lloyd E. ; Prineas, Ronald J. ; Evans, Gregory W. ; Heiss, Gerardo. / Hypertension, Blood Pressure, and Heart Rate Variability : The Atherosclerosis Risk in Communities (ARIC) Study. In: Hypertension. 2003 ; Vol. 42, No. 6. pp. 1106-1111.
@article{2b20677a6ebd4bf7b536619800d84c96,
title = "Hypertension, Blood Pressure, and Heart Rate Variability: The Atherosclerosis Risk in Communities (ARIC) Study",
abstract = "Dysregulation of the autonomic nervous system has been implicated in the development of hypertension. Heart rate variability is a noninvasive tool to quantitatively estimate cardiac autonomic activity and has been used to document decreased cardiac autonomic activity in hypertension. The ability of decreased heart rate variability to predict incident hypertension has not been well studied, and there are no studies of whether hypertension leads to changes in heart rate variability. We investigated the temporal sequence linking hypertension, blood pressure, and heart rate variability in a population-based cohort of 11 061 individuals aged 45 to 54 years at baseline. Individuals with hypertension had decreased heart rate variability at baseline, and this association was present across the full blood pressure range. Among 7099 individuals without hypertension at baseline, low heart rate variability predicted greater risk of incident hypertension over 9 years of follow-up. The hazard ratio (95{\%} confidence interval [CI]) for the lowest compared with the highest quartile of the standard deviation of normal-to-normal R-R intervals was 1.24 (95{\%} CI, 1.10-1.40), for the root mean square of successive differences in normal-to-normal R-R intervals was 1.36 (95{\%} CI, 1.21-1.54), and for R-R interval was 1.44 (95{\%} CI, 1.27-1.63). Over 9 years, there was no measurable difference in the rate of change in heart rate variability among those with and without hypertension, although the differences in heart rate variability at follow-up were smaller than those at baseline. These findings thus support the thesis that the autonomic nervous system is involved in the development of hypertension, yet suggest that differences in the autonomic profile of hypertensives and normotensives do not increase with time.",
author = "Schroeder, {Emily B.} and Duanping Liao and Chambless, {Lloyd E.} and Prineas, {Ronald J.} and Evans, {Gregory W.} and Gerardo Heiss",
year = "2003",
month = "12",
day = "1",
doi = "10.1161/01.HYP.0000100444.71069.73",
language = "English (US)",
volume = "42",
pages = "1106--1111",
journal = "Hypertension",
issn = "0194-911X",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

Hypertension, Blood Pressure, and Heart Rate Variability : The Atherosclerosis Risk in Communities (ARIC) Study. / Schroeder, Emily B.; Liao, Duanping; Chambless, Lloyd E.; Prineas, Ronald J.; Evans, Gregory W.; Heiss, Gerardo.

In: Hypertension, Vol. 42, No. 6, 01.12.2003, p. 1106-1111.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Hypertension, Blood Pressure, and Heart Rate Variability

T2 - The Atherosclerosis Risk in Communities (ARIC) Study

AU - Schroeder, Emily B.

AU - Liao, Duanping

AU - Chambless, Lloyd E.

AU - Prineas, Ronald J.

AU - Evans, Gregory W.

AU - Heiss, Gerardo

PY - 2003/12/1

Y1 - 2003/12/1

N2 - Dysregulation of the autonomic nervous system has been implicated in the development of hypertension. Heart rate variability is a noninvasive tool to quantitatively estimate cardiac autonomic activity and has been used to document decreased cardiac autonomic activity in hypertension. The ability of decreased heart rate variability to predict incident hypertension has not been well studied, and there are no studies of whether hypertension leads to changes in heart rate variability. We investigated the temporal sequence linking hypertension, blood pressure, and heart rate variability in a population-based cohort of 11 061 individuals aged 45 to 54 years at baseline. Individuals with hypertension had decreased heart rate variability at baseline, and this association was present across the full blood pressure range. Among 7099 individuals without hypertension at baseline, low heart rate variability predicted greater risk of incident hypertension over 9 years of follow-up. The hazard ratio (95% confidence interval [CI]) for the lowest compared with the highest quartile of the standard deviation of normal-to-normal R-R intervals was 1.24 (95% CI, 1.10-1.40), for the root mean square of successive differences in normal-to-normal R-R intervals was 1.36 (95% CI, 1.21-1.54), and for R-R interval was 1.44 (95% CI, 1.27-1.63). Over 9 years, there was no measurable difference in the rate of change in heart rate variability among those with and without hypertension, although the differences in heart rate variability at follow-up were smaller than those at baseline. These findings thus support the thesis that the autonomic nervous system is involved in the development of hypertension, yet suggest that differences in the autonomic profile of hypertensives and normotensives do not increase with time.

AB - Dysregulation of the autonomic nervous system has been implicated in the development of hypertension. Heart rate variability is a noninvasive tool to quantitatively estimate cardiac autonomic activity and has been used to document decreased cardiac autonomic activity in hypertension. The ability of decreased heart rate variability to predict incident hypertension has not been well studied, and there are no studies of whether hypertension leads to changes in heart rate variability. We investigated the temporal sequence linking hypertension, blood pressure, and heart rate variability in a population-based cohort of 11 061 individuals aged 45 to 54 years at baseline. Individuals with hypertension had decreased heart rate variability at baseline, and this association was present across the full blood pressure range. Among 7099 individuals without hypertension at baseline, low heart rate variability predicted greater risk of incident hypertension over 9 years of follow-up. The hazard ratio (95% confidence interval [CI]) for the lowest compared with the highest quartile of the standard deviation of normal-to-normal R-R intervals was 1.24 (95% CI, 1.10-1.40), for the root mean square of successive differences in normal-to-normal R-R intervals was 1.36 (95% CI, 1.21-1.54), and for R-R interval was 1.44 (95% CI, 1.27-1.63). Over 9 years, there was no measurable difference in the rate of change in heart rate variability among those with and without hypertension, although the differences in heart rate variability at follow-up were smaller than those at baseline. These findings thus support the thesis that the autonomic nervous system is involved in the development of hypertension, yet suggest that differences in the autonomic profile of hypertensives and normotensives do not increase with time.

UR - http://www.scopus.com/inward/record.url?scp=0346218190&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0346218190&partnerID=8YFLogxK

U2 - 10.1161/01.HYP.0000100444.71069.73

DO - 10.1161/01.HYP.0000100444.71069.73

M3 - Article

VL - 42

SP - 1106

EP - 1111

JO - Hypertension

JF - Hypertension

SN - 0194-911X

IS - 6

ER -