Supplementary_material.pdf (271.68 kB)

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

Download (271.68 kB)
posted on 01.02.2021, 19:24 by Christian S Hansen, Marit E Jørgensen, Marek Malik, Daniel R Witte, Eric J Brunner, Adam G. Tabák, Mika Kivimäki, Dorte Vistisen

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 age 60, SD=5.9 years, 70% men). rHR and/or 6 indices of HRV were measured. Associations of 5-year change in 5-minute rHR and HRV with fatal- and non-fatal CVD and all-cause mortality or the composite of the two were assessed with adjustments for relevant confounders. Effect modification by glycemic state was tested.


At baseline, 63% of participants were normoglycemic, 29% had prediabetes and 8% had diabetes. During a median (IQR) follow-up of 11.9 (11.4;12.3) years, 298 participants (6.5%) experienced a CVD event and 279 (6.1%) died from 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 beats per minute higher baseline level showed a 11.4% higher rate of all-cause mortality (95%CI:1.0;22.9%, P=0.032). Glycemic state did not modify associations.


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


The UK Medical Research Council (K013351, R024227), British Heart Foundation and the US National Institutes of Health (R01HL36310, R01AG013196) have supported collection of data in the Whitehall II study. DRW is supported by the Danish Diabetes Academy, which is funded by an unrestricted grant from the Novo Nordisk Foundation. MK had research grants from the UK Medical Research Council (K013351, R024227), the US National Institute on Aging (R01AG056477), NordForsk, the Academy of Finland (311492) and Helsinki Institute of Life Science during the conduct of the study. MM has a New Horizons grant from British Heart Foundation (NH/16/2/32499).