The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors
Abstract
Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. The understanding of the risk factors for CVD may yield important insights into the prevention, etiology, course, and treatment of this major public health concern. Autonomic imbalance, characterized by a hyperactive sympathetic system and a hypoactive parasympathetic system, is associated with various pathological conditions. Over time, excessive energy demands on the system can lead to premature aging and diseases. Therefore, autonomic imbalance may be a final common pathway to increased morbidity and mortality from a host of conditions and diseases, including cardiovascular disease. Heart rate variability (HRV) may be used to assess autonomic imbalances, diseases and mortality. Parasympathetic activity and HRV have been associated with a wide range of conditions including CVD. Here we review the evidence linking HRV to established and emerging modifiable and non-modifiable CVD risk factors such as hypertension, obesity, family history and work stress. Substantial evidence exists to support the notion that decreased HRV precedes the development of a number of risk factors and that lowering risk profiles is associated with increased HRV. We close with a suggestion that a model of autonomic imbalance may provide a unifying framework within which to investigate the impact of risk factors, including psychosocial factors and work stress, on cardiovascular disease.
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A large range of conditions not directly related to stress, such as obesity, low aerobic fitness and old age, are associated with chronic low HRV.
“A large range of conditions that are, at first glance, not directly related to stress, such as obesity, low aerobic fitness and old age (Thayer et al., 2010;Zulfiqar et al., 2010) and many other 'low capacity' bodily states (Thayer et al., 2010), are still associated with chronic low HRV.”
From Exposed to events that never happen: generalized unsafety, the default stress response, and prolonged autonomic activity (2017) · cites this paper as Thayer et al., 2010
In all conditions that compromise bodily fitness, the stress response is more on edge, as reflected in a low HRV.
“Therefore, in all these conditions the stress response is more 'on edge', as reflected in a low HRV (Thayer et al., 2010;Zulfiqar et al., 2010).”
From Exposed to events that never happen: generalized unsafety, the default stress response, and prolonged autonomic activity (2017) · cites this paper as Thayer et al., 2010
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- Authors
- Thayer, J. F., Yamamoto, S. S., & Brosschot, J. F.
- Affiliations
- Heidelberg University (DE)
- Leiden University (NL)
- Corresponding author
- Thayer, Julian F.
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2010-05
- Volume
- 141
- Issue
- 2
- Pages
- 122-131
- ISSN
- 0167-5273 (ISSN-L)
- OpenAlex
- W2136429434
- Cited by
- 2,276
- References
- 89
- Citations by year
- 2026: 140 · 2025: 151 · 2024: 166 · 2023: 208 · 2022: 170 · 2021: 194 · 2020: 180 · 2019: 174 · 2018: 156 · 2017: 153 · 2016: 148 · 2015: 105 · 2014: 103 · 2013: 95 · 2012: 72
- FWCI
- 6.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- International Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
- Keywords
- autonomic imbalance, heart rate variability, cardiovascular risk factors, sympathetic hyperactivity, parasympathetic dysfunction, hypertension, obesity, family history (medicine), occupational stress, psychosocial factors, cardiovascular disease prevention
- MeSH terms
- Age Factors, Autonomic Nervous System, Cardiovascular Diseases, Cholesterol, Diabetes Mellitus, Heart Rate, Humans, Hypertension, Risk Factors, Smoking, Stress, Psychological, Genetic Predisposition to Disease, Overweight, Sedentary Behavior
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