Heart Rate and Heart Rate Variability Changes Are Not Related to Future Cardiovascular Disease and Death in People With and Without Dysglycemia: A Downfall of Risk Markers? The Whitehall II Cohort Study

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  • Christian S Hansen, Steno Diabet Ctr Copenhagen, Steno Diabetes Center, National Public Health Institute, Denmark
  • Marit E Jørgensen, Steno Diabet Ctr Copenhagen, Steno Diabetes Center
  • ,
  • Marek Malik, Imperial Coll London, Imperial College London, Imperial Clin Trials Unit, Department of Internal Medicine and Cardiology, Masaryk University, Brno, United Kingdom
  • Daniel R Witte
  • Eric J Brunner, University College London, London, United Kingdom
  • Adam G Tabák, University College London, London, Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Department of Public Health, Semmelweis University, Budapest, United Kingdom
  • Mika Kivimäki, University College London, London, United Kingdom
  • Dorte Vistisen, Steno Diabet Ctr Copenhagen, Steno Diabetes Center, Denmark

OBJECTIVE: Higher resting heart rate (rHR) and lower heart rate variability (HRV) are associated with increased risk of cardiovascular disease (CVD) and all-cause mortality in people with and without diabetes. It is unknown whether temporal changes in rHR and HRV may contribute to this risk. We investigated associations between 5-year changes in rHR and HRV and risk of future CVD and death, taking into account participants' baseline glycemic state.

RESEARCH DESIGN AND METHODS: In this prospective, population-based cohort study we investigated 4,611 CVD-free civil servants (mean [SD] age, 60 [5.9] years; 70% men). We measured rHR and/or six indices of HRV. Associations of 5-year change in 5-min rHR and HRV with fatal and nonfatal CVD and all-cause mortality or the composite of the two were assessed, with adjustments made for relevant confounders. Effect modification by glycemic state was tested.

RESULTS: At baseline, 63% of participants were normoglycemic, 29% had prediabetes, and 8% had diabetes. During a median (interquartile range) follow-up of 11.9 (11.4; 12.3) years, 298 participants (6.5%) experienced a CVD event and 279 (6.1%) died of non-CVD-related causes. We found no association between 5-year changes in rHR and HRV and future events. Only baseline rHR was associated with all-cause mortality. A 10 bpm-higher baseline HR level was associated with a 11.4% higher rate of all-cause mortality (95% CI 1.0-22.9%; P = 0.032). Glycemic state did not modify associations.

CONCLUSIONS: Changes in rHR and HRV and possibly also baseline values of these measures are not associated with future CVD or death in people with or without dysglycemia.

Original languageEnglish
Article numberdc202490
JournalDiabetes Care
Number of pages8
ISSN0149-5992
DOIs
Publication statusE-pub ahead of print - 1 Feb 2021

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