한빛사 논문
Jeonggyu Kang 1 2, Yoosoo Chang 2 3 4, Yejin Kim 2, Hocheol Shin 2 5, Seungho Ryu 2 3 4
1Total Healthcare Center (J.K.), Sungkyunkwan University, Seoul, South Korea.
2Center for Cohort Studies, Total Healthcare Center (J.K., Y.C., Y.K., H.S., S.R.), Sungkyunkwan University, Seoul, South Korea.
3Department of Occupational and Environmental Medicine (Y.C., S.R.), Sungkyunkwan University, Seoul, South Korea.
4Kangbuk Samsung Hospital, School of Medicine and Department of Clinical Research Design and Evaluation, SAIHST (Y.C., S.R.), Sungkyunkwan University, Seoul, South Korea.
5Department of Family Medicine (H.S.), Sungkyunkwan University, Seoul, South Korea.
Correspondence to: Yoosoo Chang, Seungho Ryu
Abstract
Background:
The role of ultrashort-term heart rate variability (HRV) and its temporal changes in incident hypertension are unknown. We aimed to investigate the association between 10-second HRV, its changes, and incident hypertension in adults aged <40 years and older.
Methods:
This cohort study included 232 587 Koreans (mean age 37.6 years) without hypertension. Hypertension was defined according to the 2017 American College of Cardiology and American Heart Association hypertension guidelines. HRV, including the root mean square of successive RR interval differences and the SD of normal-to-normal RR intervals, was estimated using standard 12-lead, 10-second electrocardiography.
Results:
During a median follow-up of 3.8 years, 40 268 hypertension cases were identified (incidence rates: 36.1 and 67.9 per 1000 person-years for young and older participants, respectively). An inverse association was observed between HRV and hypertension risk, in a dose-dependent manner. The multivariable-adjusted hazard ratios (95% CIs) for hypertension comparing the first to the fifth quintiles of root mean square of successive RR interval difference and SD of normal-to-normal RR interval were 1.58 (1.52–1.63) and 1.35 (1.30–1.39), respectively. These associations were stronger in young adults than in older adults. In a subsample of 150 301 participants, compared with stable HRV, an increase in HRV over time was also inversely associated with incident hypertension.
Conclusions:
A higher HRV and its increase over time on a 10-second electrocardiography were associated with a lower risk of hypertension. Our findings indicate that autonomic function, estimated using 10-second standard electrocardiography, plays a role in predicting hypertension, with a stronger effect in young adults.
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