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From National Heart, Lung, and Blood Institute's Framingham Heart
Study, Framingham, Mass (J.P.S., M.G.L., H.T., J.C.E., C.J.O., D.L.); the
National Heart, Lung, and Blood Institute, Bethesda, Md (C.J.O., D.L.); the
Division of Epidemiology and Preventive Medicine, Boston University School of
Medicine, Boston, Mass (J.P.S., M.G.L., J.C.E., D.L.); the Divisions of
Cardiology and Clinical Epidemiology, Beth Israel Hospital, Boston, Mass
(D.L.); the Cardiac Unit, Department of Medicine, Massachusetts General
Hospital, Harvard Medical School, Boston, Mass (C.J.O.); and Kansai Medical
University, Osaka, Japan (H.T.).
Abstract—Heart rate variability
(HRV) is a useful noninvasive tool to assess cardiac autonomic
function. The purpose of this study was to (1) compare measures of HRV
between hypertensive and normotensive subjects and (2) examine the role
of HRV as a predictor of new-onset hypertension. The first 2 hours of
ambulatory ECG recordings obtained from 931 men and 1111 women
attending a routine examination at the Framingham Heart Study were
processed for HRV. Three time-domain and 5 frequency-domain
variables were studied: standard deviation of normal RR intervals
(SDNN), percentage of differences between adjacent normal RR intervals
exceeding 50 milliseconds, square root of the mean of squared
differences between adjacent normal RR intervals, total power (0.01 to
0.40 Hz), high frequency power (HF, 0.15 to 0.40 Hz), low frequency
power (LF, 0.04 to 0.15 Hz), very low frequency power (0.01 to 0.04
Hz), and LF/HF ratio. On cross-sectional analysis, HRV was
significantly lower in hypertensive men and women. Among 633 men and
801 women who were normotensive at baseline (systolic blood
pressure <140 mm Hg and diastolic blood pressure
<90 mm Hg and not receiving antihypertensive treatment), 119 men
and 125 women were newly hypertensive at follow-up 4 years later. After
adjustment for factors associated with hypertension, multiple logistic
regression analysis revealed that LF was associated with
incident hypertension in men (odds ratio per SD decrement [OR], 1.38;
95% confidence interval [CI], 1.04 to 1.83) but not in women (OR,
1.12; 95% CI, 0.86 to 1.46). SDNN, HF, and LF/HF were not associated
with hypertension in either sex. HRV is reduced in men and women with
systemic hypertension. Among normotensive men, lower HRV was associated
with greater risk for developing hypertension. These findings are
consistent with the hypothesis that autonomic dysregulation is
present in the early stage of hypertension.
© 1998 American Heart Association, Inc.
Scientific Contributions
Reduced Heart Rate Variability and New-Onset Hypertension
Insights Into Pathogenesis of Hypertension: The Framingham Heart Study
Key Words: heart rate • hypertension, essential • Framingham Heart Study • autonomic nervous system • pathogenesis
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