Relationship between heart rate variability and carotid intima‐media thickness in the Brazilian Longitudinal Study of Adult Health – ELSA‐Brasil

Abstract

Background Both increased carotid intima-media thickness (cIMT) and low heart rate variability (HRV) have been associated with cardiovascular mortality and morbidity. Thus, the aim of this study was to investigate whether cardio autonomic alterations are accompanied or not by subclinical atherosclerosis in participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods cIMT measures and 5-min HRV analyses were performed in apparently healthy adults. Heart rate variability was evaluated by linear time and frequency domain analyses. cIMT was defined as the average between the mean left and mean right cIMT values and was analysed as continuous and categorized variables (P≥75 or P<75). Multiple linear models using continuous variables and multivariate logistic regression with categorized cIMT and HRV quartiles were performed. Results Out of 7256 participants eligible for analyses, 23Á4% presented cIMT ≥ 75th percentile. Heart rate variability variables were reduced in cIMT ≥ P75 in comparison with cIMT < P75: SDNN 33Á0 versus 37Á0 ms, P<0Á001; RMSSD 22Á0 versus 26Á0 ms, P<0Á001; LF 191Á0 versus 260Á0 ms 2 , P<0Á001; HF 164Á0 versus 238Á5 ms 2 , P<0Á001. In crude analysis, an increased odds ratio for cIMT ≥ P75 was verified within the lowest two quartiles of LF and HF, but significances did not remain after adjustments for anthropometric and clinical variables.Conclusions Considering the entire sample, subjects with cIMT ≥ P75 presented lower HRV values, but no independent relationships were detected between cIMT and HRV after multivariate adjustment.A previously validated, comprehensive set of questionnaires, clinical measurements and laboratory tests were carried out. Sociodemographic factors and previous medical history were

Association between Levels of Urine Di-(2-ethylhexyl)phthalate Metabolites and Heart Rate Variability in Young Adults

“…Endothelial dysfunction was also associated with decreased HRV in healthy adults and patients with stable coronary artery disease or diabetes mellitus [39][40][41]. Increased carotid intima-media thickness was associated with decreased HRV in previous studies [42,43]. Our previous studies showed that urinary phthalate metabolites were associated with endothelial dysfunction, insulin resistance, and increased carotid intima-media thickness [13,14,44].…”

Association of coronary artery calcium with heart rate variability in the Brazilian Longitudinal Study of Adult Health - ELSA-Brasil

“…In a recent article, we detected lower HRV values in participants with high carotid intima-media thickness (cIMT), but independent relationships were not found in the overall sample ( 36 ). It is important to note that these different findings may be related to CAC and cIMT distinct performances in relation to subclinical atherosclerosis progression: cIMT reflects the first stages while CAC reflects later stages of the atherosclerotic process ( 37 ).…”

“…Cardiac autonomic impairment has also been associated with an increased risk of fatal and nonfatal CAD ( 6 , 7 ) and can be measured by heart rate variability (HRV) analysis. The clinical significance of this measure is increasingly recognized as an important physiological marker and a diagnostic tool in the detection of autonomic impairment and prediction/prognosis of several cardiac and non-cardiac disorders ( 8 - 13 ). Essentially, a combination of higher values of standard HRV indices under resting conditions means an adequate coupling between the sympathetic and the parasympathetic branches of the autonomic nervous system (ANS).…”

Association Between Levels of Urine Di-(2-ethylhexyl)phthalate Exposure, a Potentially Harmful and Invisible Chemical, and Heart Rate Variability in Young Adults

“…Endothelial dysfunction was also associated with decreased HRV in healthy adults and patients with stable coronary artery disease or diabetes mellitus [39][40][41]. Increased carotid intima-media thickness was associated with decreased HRV in previous studies [42,43]. Our previous studies showed that urinary phthalate metabolites were associated with endothelial dysfunction, insulin resistance and increased carotid intima-media thickness [12,13,44].…”