Association of health behaviour with heart rate variability: a population-based study

Alexander Kluttig,Barbara Schumann,Karin H Greiser,Karl Werdan,Jan A Kors,Cees A Swenne,Oliver Kuss,Johannes Haerting,Hendrik Schmidt

doi:10.1186/1471-2261-10-58

Abstract

BackgroundReduced heart rate variability (HRV), a non-invasive marker of autonomic dysfunction, and an unhealthy lifestyle are associated with an increased morbidity and mortality of cardiovascular diseases (CVD). The autonomic dysfunction is a potential mediator of the association of behavioural risk factors with adverse health outcomes. We studied the association of HRV with behavioural risk factors in an elderly population.MethodsThis analysis was based on the cross-sectional data of 1671 participants (age range, 45-83 years) of the prospective, population-based Cardiovascular Disease, Living and Ageing in Halle (CARLA) Study. Physical activity, smoking habits, alcohol consumption and dietary patterns were assessed in standardized interviews. Time and frequency domain measures of HRV were computed from 5-min segments of highly standardized 20-min electrocardiograms. Their association with behavioural risk factors was determined by linear and non-parametric regression modelling.ResultsThere were only weak and inconsistent associations of higher physical activity, moderate consumption of alcohol, and non-smoking with higher time and frequency domain HRV in both sexes, and no association with dietary pattern. Results changed only marginally by excluding subjects with CVD, diabetes mellitus and use of cardioactive medication.ConclusionWe hypothesized that HRV is associated with behavioural factors and therefore might be a mediator of the effect of behavioural risk factors on CVD, but this hypothesis was not confirmed by our results. These findings support the interpretation that there may be no true causal association of behavioural factors with HRV.

Highlights

Reduced heart rate variability (HRV), a non-invasive marker of autonomic dysfunction, and an unhealthy lifestyle are associated with an increased morbidity and mortality of cardiovascular diseases (CVD)
We hypothesized that physical activity and a favourable dietary pattern are directly associated with HRV, smoking is associated with reduced HRV, and alcohol consumption shows a nonlinear J-shaped association with HRV
We hypothesized that HRV is associated with behavioural factors and might be a mediator of the effect of behavioural CVD risk factors on CVD events, but this hypothesis was not confirmed by our results

Summary

Introduction

Reduced heart rate variability (HRV), a non-invasive marker of autonomic dysfunction, and an unhealthy lifestyle are associated with an increased morbidity and mortality of cardiovascular diseases (CVD). Epidemiological studies provide evidence that a healthy lifestyle (e.g., physical activity, not smoking, healthy diet, and moderate consumption of alcohol) reduces morbidity and mortality due to cardiovascular causes [1]. Reduced heart rate variability (HRV), a marker of autonomic dysfunction, has been shown to be associated with an increased risk of incident myocardial infarction, cardiovascular mortality, and death from other causes in general populations [2,3,4], and to be associated with a poor prognosis of cardiovascular diseases (CVD) [5,6]. We hypothesized that physical activity and a favourable dietary pattern are directly associated with HRV, smoking is associated with reduced HRV, and alcohol consumption shows a nonlinear J-shaped association with HRV

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