Published Online
on October 27, 2003

A more recent version of this article appeared on December 1, 2003

This Article Full Text (PDF) All Versions of this Article: 42/6/1106    most recent 01.HYP.0000100444.71069.73v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Schroeder, E. B. Articles by Heiss, G. Search for Related Content PubMed PubMed Citation Articles by Schroeder, E. B. Articles by Heiss, G. Related Collections Hypertension - basic studies Epidemiology Autonomic, reflex, and neurohumoral control of circulation

Submitted on August 8, 2003
Revised on August 29, 2003

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; and Gerardo Heiss^*

From the Departments of Epidemiology (E.B.S., G.H.) and Biostatistics (L.E.C.), School of Public Health, University of North Carolina, Chapel Hill; the Department of Health Evaluation Sciences (D.L.), Pennsylvania State University College of Medicine, Hershey, Pa; and the Department of Public Health Sciences (R.J.W., G.W.E.), Wake Forest University School of Medicine, Winston-Salem, NC.

^* To whom correspondence should be addressed. E-mail: gerardo-heiss{at}unc.edu.

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.

Key words: autonomic nervous system • heart rate • heart rate variability • hypertension, detection and control • blood pressure

This article has been cited by other articles:

				K. S. Heffernan, S. Y. Jae, V. J. Vieira, G. A. Iwamoto, K. R. Wilund, J. A. Woods, and B. Fernhall C-reactive protein and cardiac vagal activity following resistance exercise training in young African-American and white men Am J Physiol Regulatory Integrative Comp Physiol, April 1, 2009; 296(4): R1098 - R1105. [Abstract] [Full Text] [PDF]

				H. S. Hwang, Y. S. Kim, Y. H. Ryu, J. E. Lee, Y. S. Lee, E. J. Yang, M. S. Lee, and S.-M. Choi Electroacupuncture Delays Hypertension Development through Enhancing NO/NOS Activity in Spontaneously Hypertensive Rats Evid. Based Complement. Altern. Med., October 7, 2008; (2008) nen064v1. [Abstract] [Full Text] [PDF]

				J. Yarnell Stress at work--an independent risk factor for coronary heart disease? Eur. Heart J., March 1, 2008; 29(5): 579 - 580. [Full Text] [PDF]

				P. L. Lutsey, L. M. Steffen, and J. Stevens Dietary Intake and the Development of the Metabolic Syndrome: The Atherosclerosis Risk in Communities Study Circulation, February 12, 2008; 117(6): 754 - 761. [Abstract] [Full Text] [PDF]

				P. B. Mellen, A. J. Bleyer, T. P. Erlinger, G. W. Evans, F. J. Nieto, L. E. Wagenknecht, M. R. Wofford, and D. M. Herrington Serum Uric Acid Predicts Incident Hypertension in a Biethnic Cohort: The Atherosclerosis Risk in Communities Study Hypertension, December 1, 2006; 48(6): 1037 - 1042. [Abstract] [Full Text] [PDF]

				M. A. Kizilbash, M. R. Carnethon, C. Chan, D. R. Jacobs, S. Sidney, and K. Liu The temporal relationship between heart rate recovery immediately after exercise and the metabolic syndrome: the CARDIA study Eur. Heart J., July 1, 2006; 27(13): 1592 - 1596. [Abstract] [Full Text] [PDF]

				J.-B. Choi, S. Hong, R. Nelesen, W. A. Bardwell, L. Natarajan, C. Schubert, and J. E. Dimsdale Age and Ethnicity Differences in Short-Term Heart-Rate Variability Psychosom Med, May 1, 2006; 68(3): 421 - 426. [Abstract] [Full Text] [PDF]

				E. B. Schroeder, L. E. Chambless, D. Liao, R. J. Prineas, G. W. Evans, W. D. Rosamond, and G. Heiss Diabetes, Glucose, Insulin, and Heart Rate Variability: The Atherosclerosis Risk in Communities (ARIC) study Diabetes Care, March 1, 2005; 28(3): 668 - 674. [Abstract] [Full Text] [PDF]