(Circulation. 2000;102:1239.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
Low Heart Rate Variability in a 2-Minute Rhythm Strip Predicts Risk of Coronary Heart Disease and Mortality From Several Causes
The ARIC Study
From the Division of Human Nutrition and Epidemiology (J.D., E.S.), Wageningen Agricultural University, Wageningen, the Netherlands; Institute for Research in Extramural Medicine (J.D.), Vrije Universiteit Amsterdam (the Netherlands); Division of Epidemiology (R.C., A.F., P.H.), School of Public Health, University of Minnesota, Minn; Department of Epidemiology (D.L.), School of Public Health, University of North Carolina (Chapel Hill); and Department of Cardiology (C.S.), University Hospital, Leiden, the Netherlands.
Correspondence to Dr Jacqueline M. Dekker, Institute for Research in Extramural Medicine, Faculty of Medicine Vrije Universiteit, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands. E-mail JM.Dekker.EMGO{at}med.vu.nl
Background—Low heart rate variability (HRV) is associated with a higher risk of death in patients with heart disease and in elderly subjects and with a higher incidence of coronary heart disease (CHD) in the general population.
Methods and Results—We studied the predictive value of HRV for CHD and death from several causes in a population study of 14 672 men and women without CHD, aged 45 to 65, by using the case-cohort design. At baseline, in 1987 to 1989, 2-minute rhythm strips were recorded. Time-domain measures of HRV were determined in a random sample of 900 subjects, for all subjects with incident CHD (395 subjects), and for all deaths (443 subjects) that occurred through 1993. Relative rates of incident CHD and cause-specific death in tertiles of HRV were computed with Poisson regression for the case-cohort design. Subjects with low HRV had an adverse cardiovascular risk profile and an elevated risk of incident CHD and death. The increased risk of death could not be attributed to a specific cause and could not be explained by other risk factors.
Conclusions—Low HRV was associated with increased risk of CHD and death from several causes. It is hypothesized that low HRV is a marker of less favorable health.
Key Words: heart rate • nervous system, autonomic • coronary disease • mortality • heart diseases
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