Heart rate variability and lifetime risk of cardiovascular disease: the Atherosclerosis Risk in Communities Study

The purpose of this study was to estimate the heart rate variability (HRV)–related lifetime cardiovascular disease (CVD) risk. We followed 9744 participants without baseline CVD and used a life-table approach to estimate lifetime CVD risk (coronary heart disease, heart failure, and stroke) from 45 through 85 years according to several HRV measures (the SD of RR intervals [SDNN], the root mean square of successive differences of successive RR intervals, the mean of all normal RR intervals [meanNN], low-frequency [LF] and high-frequency [HF] power, and the LF/HF ratio). During 192,110 person-years of follow-up, we documented 2856 CVD events. Cox regression analyses with the false discovery rate method correction showed independent associations of SDNN, meanNN, LF, and LF/HF in women with CVD. Lifetime CVD risks in the lowest compared with the highest tertile were significantly increased in men for LF/HF (51.3% [95% confidence interval, 47.3–54.7] vs. 43.9% [40.1–47.2]), and in women for SDNN (39.4% [36.0–43.0] vs. 29.9% [26.3–33.0]), meanNN (39.3% [35.7–42.7] vs. 28.9% [25.7–31.7]), LF (39.4% [35.9–43.0] vs. 30.0% [26.2–33.2]), and LF/HF (37.6% [33.9–40.9] vs. 30.0% [26.8–32.7]). Greater HRV was modestly associated with lower lifetime CVD risk.