Low heart rate variability in a 2-minute rhythm strip predicts risk of coronary heart disease and mortality from several causes - The ARIC study

Background-Low heart rate variability (HRV) is associated with a higher ris k of death in patients with heart disease and in elderly subjects and with a higher incidence of coronary heart disease (CHD) in the general populatio n. Methods and Results-We studied the predictive value of HRV for CHD and deat h from several causes in a population study of 14 672 men and women without CHD, aged 45 to 65, by using the case-cohort design. At baseline, in 1987 to 1989, 2-minute rhythm strips were recorded. Time-domain measures of HRV were determined in a random sample of 900 subjects, for all subjects with i ncident CHD (395 subjects), and for all deaths (443 subjects) that occurred through 1993. Relative rates of incident CHD and cause-specific death in t ertiles of HRV were computed with Poisson regression for the case-cohort de sign. Subjects with low HRV had an adverse cardiovascular risk profile and an elevated risk of incident CHD and death. The increased risk of death cou ld not be attributed to a specific cause and could not be explained by othe r risk factors, Conclusions-Low HRV was associated with increased risk of CHD and death fro m several causes, It is hypothesized that low HRV is a marker of less favor able health.