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      Determinants of Short-Period Heart Rate Variability in the General Population

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          Abstract

          Decreased heart rate variability (HRV) is associated with a worse prognosis in a variety of diseases and disorders. We evaluated the determinants of short-period HRV in a random sample of 149 middle-aged men and 137 women from the general population. Spectral analysis was used to compute low-frequency (LF), high-frequency (HF) and total-frequency power. HRV showed a strong inverse association with age and heart rate in both sexes with a more pronounced effect of heart rate on HRV in women. Age and heart rate-adjusted LF was significantly higher in men and HF higher in women. Significant negative correlations of BMI, triglycerides, insulin and positive correlations of HDL cholesterol with LF and total power occurred only in men. In multivariate analyses, heart rate and age persisted as prominent independent predictors of HRV. In addition, BMI was strongly negatively associated with LF in men but not in women. We conclude that the more pronounced vagal influence in cardiac regulation in middle-aged women and the gender-different influence of heart rate and metabolic factors on HRV may help to explain the lower susceptibility of women for cardiac arrhythmias.

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          Most cited references 4

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          Hypertension and associated metabolic abnormalities--the role of insulin resistance and the sympathoadrenal system.

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            Heart rate variability and heart rate in healthy volunteers. Is the female autonomic nervous system cardioprotective?

            Heart rate variability has been proposed as an indicator of cardiovascular health. Since women have a lower cardiovascular risk, we hypothesized that there are gender differences in autonomic modulation. In 276 healthy subjects (135 women, 141 men) between 18 and 71 years of age, 24 h heart rate and heart rate variability were determined. All heart rate variability parameters, except for pNN50 and high frequency power, were higher in men. After adjustment for heart rate, we obtained gender differences for: the standard deviation (P=0.049), the standard deviation of the 5 min average (P=0.047), low frequency power (absolute values, P=0.002; normalized units, P<0.001) and ratio low frequency/high frequency (P<0.001). There were no significant gender differences in heart rate variability parameters denoting vagal modulation. Gender differences were confined to age categories of less than 40 years of age. The majority of heart rate variability parameters decreased with age. Only in men, was a higher body mass index associated with a higher heart rate and with lower heart rate variability parameters (P<0.001). Cardiac autonomic modulation as determined by heart rate variability, is significantly lower in healthy women compared to healthy men. We hypothesize that this apparently paradoxical finding may be explained by lower sympathetic activity (low frequency power) in women. This may provide protection against arrhythmias and against the development of coronary heart disease.
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              Associations of smoking, alcohol and physical activity with risk factors for coronary heart disease and diabetes in the first follow-up cohort of the Heart Disease and Diabetes Risk Indicators in a Screened Cohort study (HDDRISC-1).

              To investigate the associations between risk factors for cardiovascular disease and cigarette smoking, alcohol intake, and physical activity in a group of predominantly healthy men. Cohort study with baseline characterisation, clinical follow-up, and identification of predictors of coronary artery disease and diabetes. University hospital metabolic day ward. Participants in a company health programme (n=742). Routine haematology and biochemistry, cholesterol, triglycerides, high density lipoprotein (HDL) cholesterol (on a subset of 522 subjects), and glucose and insulin levels during a 3 h oral glucose tolerance test (OGTT). Independent associations with previous cigarette smoking included high uric acid and low HDL cholesterol, and with current cigarette smoking, high haemoglobin and white cell count and low OGTT insulin. Increasing alcohol intake was associated with increasing blood pressure, uric acid, HDL cholesterol and fasting glucose. The moderate range of exercise intensity in this cohort was associated with decreasing systolic blood pressure, fasting insulin and OGTT glucose and insulin. Factor analysis distinguished principal factors comprising features of the metabolic syndrome with low physical activity, and high white cell count, high haemoglobin concentration and low HDL cholesterol with increasing previous and current cigarette smoking and alcohol intake. Some characteristics of the metabolic syndrome were seen with previous but not current smoking habit. Regular alcohol consumption was associated with mainly unfavourable metabolic characteristics, although there was an independent beneficial association with HDL cholesterol. The improved metabolic syndrome profile seen with increasing exercise is consistent with even moderate degrees of physical activity having beneficial effects on metabolism.
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                Author and article information

                Journal
                CRD
                Cardiology
                10.1159/issn.0008-6312
                Cardiology
                S. Karger AG
                0008-6312
                1421-9751
                2001
                July 2001
                20 July 2001
                : 95
                : 3
                : 131-138
                Affiliations
                aInstitute of Epidemiology and Social Medicine and bInstitute of Clinical Chemistry and Laboratory Medicine, University of Münster, and cDepartment of Medicine I, Central Hospital Augsburg, Academic Training Clinic University Munich, Germany; dDepartment of Social Medicine and Department of Cardiology, Hadassah Medical Organization and Hebrew University-Hadassah School of Public Health, Jerusalem, Israel
                Article
                47359 Cardiology 2001;95:131–138
                10.1159/000047359
                11474158
                © 2001 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Tables: 6, References: 28, Pages: 8
                Categories
                Arrhythmias, Electrophysiology, and Electrocardiography

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