Visit-to-Visit Heart Rate Variability Is Positively Associated With the Risk of Adverse Cardiovascular Outcomes

Abstract

IntroductionPrevious studies found visit-to-visit heart rate variability (VVHRV) may be positively associated with risks of several cardiovascular events, but whether VVHRV affected the benefit of intensive blood pressure control remained unknown. In this study, we assessed the risk of the composite cardiovascular outcomes associated with VVHRV among the older patients with hypertension and evaluated whether the benefit of intensive blood pressure control in the prevention of the composite cardiovascular outcomes was consistent in the context of elevated VVHRV.MethodsThis was a post-hoc analysis of the Systolic Blood Pressure Intervention Trial (SPRINT). We explored the relationship between VVHRV and the composite cardiovascular outcomes by multivariate Cox proportional hazard regressions. The primary endpoint was the composite cardiovascular outcomes, same as SPRINT, defined as a composite of myocardial infarction, stroke, heart failure, and/or death from cardiovascular causes. We used multiple adjustment models for all regressions.ResultsNine thousand two hundred and fourty-seven patients from the SPRINT were included in our analysis. We found a positive association between VVHRV and the risk of composite cardiovascular outcomes among the elderly with hypertension. Per 1 CV increment in HRCV, the hazard ratio of the risk of composite cardiovascular outcomes was 1.04 (95CI: 1.03, 1.05) in the fully adjusted Model. The benefit of intensive blood pressure control in managing cardiovascular events was consistent in different VVHRV subgroups. There was no significant interaction in other confounders.ConclusionWe found the VVHRV was associated with the composite cardiovascular outcomes among the elderly with hypertension, intensive blood pressure control did not change the above association, and the benefits of intensive blood pressure management were consistent across different VVHRV groups.

The impact of visit‐to‐visit heart rate variability on all‐cause mortality in atrial fibrillation

“…The influence of long-term HRV, which refers to variation over months or years, on the prognosis of patients with AF is rarely reported. Prior investigations have shown that VVHRV is linked to various adverse cardiovascular events (Zeng et al, 2022), including new-onset AF (Zhang et al, 2021).…”

“…The influence of long‐term HRV, which refers to variation over months or years, on the prognosis of patients with AF is rarely reported. Prior investigations have shown that VVHRV is linked to various adverse cardiovascular events (Zeng et al., 2022 ), including new‐onset AF (Zhang et al., 2021 ). The analysis (Zhang et al., 2021 ) based on data from the Kailuan study cohort suggested that both higher and lower VVHRV levels might elevate the risk of new‐onset AF.…”

“…Additionally, visit‐to‐visit heart rate variability (VVHRV), which represents long‐term heart rate variability, has begun to gain attention as an indicator that affects adverse endpoints. There are evidences supporting VVHRV as a predictor of all‐cause mortality in heart failure (HF) (Böhm et al., 2016 ) and in the population free of cardiovascular disease (Wang et al., 2017 ; Yang et al., 2019 ; Zeng et al., 2022 ; Zhao et al., 2021 ). However, it remains uncertain whether VVHRV affects all‐cause mortality in AF patients.…”

Visit-to-Visit Heart Rate Variability in the Prediction of Clinical Outcomes of Patients with Atrial Fibrillation

“…14 Moreover, the visit-to-visit heart rate variability (VVV-HR) has been demonstrated to be more important than only using single time point heart rate data in relation to future risk of adverse clinical events. 15 Also, high heart rates may lead to increased oxygen demands that could contribute to adverse clinical outcome, 16 including with new-onset AF. 17 As far as we are aware, the relation of VVV-HR to adverse clinical outcomes in patients with AF has never been reported.…”

Blood Pressure and Heart Rate Variability and the Impact on Pregnancy Outcomes: A Systematic Review

“…Also, visit‐to‐visit heart rate variability (HRV) is associated with higher cardiovascular risk outside pregnancy. 4 Heart rate (HR) is routinely measured by automated BP measurement devices in pregnancy but is poorly recorded in maternity records, and it is not known whether HR is related to adverse pregnancy outcomes.…”