Cardiovascular diseases, risk factors and short-term heart rate variability in an elderly general population: the CARLA study 2002–2006

  • Karin Halina Greiser
  • Alexander Kluttig
  • Barbara Schumann
  • Cees A. Swenne
  • Jan A. Kors
  • Oliver Kuss
  • Johannes Haerting
  • Hendrik Schmidt
  • Joachim Thiery
  • Karl Werdan
Cardiovascular Disease


Background: A reduced heart rate variability (HRV) is associated with worse prognosis, increased incidence of cardiovascular disease (CVD) and mortality. There are conflicting results and a lack of population-based data regarding the association of HRV with CVD risk factors and its potential role as independent cause or mediator of CVD risk. Methods: Cross-sectional data of a population-based cohort including 1,779 women and men aged 45–83 years were used to analyse associations of time and frequency domain measures of HRV (derived from 5-min ECG segments) with age, behavioural and biomedical risk factors and disease in the whole sample and in a “healthy” subgroup. Results: Age was inversely associated with all measures of HRV (mean standard deviation of normal intervals across 10-year age-groups 32.1, 26.9, 27.1 and 24.8 ms in women, 29.3, 25.9, 23.8 and 25.7 ms in men). There was no association of physical activity, current smoking or alcohol with HRV. In age-adjusted models, triglycerides, glucose, waist-to-hip ratio and diabetes were inversely associated with HRV in men and women, and low/high density cholesterol and hypertension in men only (up to 43% difference across risk factor quartiles). Multivariable adjustment and restriction to the “healthy” subgroup attenuated the associations. Conclusions: We found only weak and inconsistent associations of HRV with cardiovascular risk factors. However, these results as well as those from previous studies are still compatible with the hypothesis that short-term HRV may be a marker of ill health or a mediator of the effect of selected biomedical risk factors on CVD.


Cardiovascular disease Cardiovascular risk factors Heart rate variability Population-based study 



Angiotensin-converting enzyme


Atrial fibrillation or flutter


Blood pressure


Cardiovascular disease, living and ageing in Halle


Coronary heart disease


Congestive heart failure


Cardiovascular disease


Diastolic blood pressure


Diabetes mellitus


Glycated haemoglobin


High density lipoprotein cholesterol


High frequency power


Heart rate


Heart rate variability


Low density lipoprotein cholesterol


Ratio of low to high density lipoprotein cholesterol


Low frequency power


Ratio of low frequency power to high frequency power


Myocardial infarction


Metabolic syndrome


Statistically not significant

Q1… Q4

First (=lowest)… fourth (=highest) quartile


Risk factors


Systolic blood pressure


Standard deviation of normal intervals


Waist-to-hip ratio

95% CI

95% confidence interval

Supplementary material

10654_2009_9317_MOESM1_ESM.doc (284 kb)
(DOC 284 kb)


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Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Karin Halina Greiser
    • 1
  • Alexander Kluttig
    • 1
  • Barbara Schumann
    • 1
  • Cees A. Swenne
    • 2
  • Jan A. Kors
    • 3
  • Oliver Kuss
    • 1
  • Johannes Haerting
    • 1
  • Hendrik Schmidt
    • 5
  • Joachim Thiery
    • 4
  • Karl Werdan
    • 5
  1. 1.Institute of Medical Epidemiology, Biostatistics, and InformaticsMartin-Luther-University Halle-WittenbergHalle (Saale)Germany
  2. 2.Department of CardiologyLeiden University Medical CenterLeidenThe Netherlands
  3. 3.Department of Medical InformaticsErasmus University Medical CenterRotterdamThe Netherlands
  4. 4.Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics (ILM)University of LeipzigLeipzigGermany
  5. 5.Department of Medicine IIIMartin-Luther-University Halle-WittenbergHalle (Saale)Germany

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