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Heart rate variability in obesity and the effect of weight loss
Abstract
To investigate the effects of obesity and weight loss on cardiovascular autonomic function, we examined 28 obese patients referred for weight-reducing gastroplasty, 24 obese patients who received dietary recommendations, and 28 lean subjects. Body weight, blood pressure, and 24-hour urinary norepinephrine excretion were measured, and time and frequency domain indexes of heart rate variability (HRV) were obtained from 24-hour Holter recordings. A measure of long-term HRV, the SD of all normal RR intervals (SDANN), was used as an index of sympathetic activity and the high-frequency (HF) component of the frequency domain, reflecting short-term HRV, as an estimate of vagal activity. All 3 study groups were investigated at baseline, and the 2 obese groups were reexamined at 1-year follow-up. Obese patients had higher blood pressure, higher urinary norepinephrine excretion, and attenuated SDANN and HF values than lean subjects (p <0.01). Obese patients treated with surgery had a mean weight loss of 32 kg (28%), whereas the obese group treated with dietary recommendations remained weight stable (p <0.001). At follow-up the weight-loss group displayed decreases in blood pressure and norepinephrine excretion and showed increments in SDANN and HF values. These changes were significantly greater than those observed in the obese control group (p <0.05). Our findings suggest that obese patients have increased sympathetic activity and a withdrawal of vagal activity and that these autonomic disturbances improve after weight loss.
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“Obese patients may have more LV diastolic dysfunction, increased sympathetic activity and inflammation, and increased fatty infiltration of the atria.”
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Metadata
- Authors
- Karason, K., Mølgaard, H., Wikstrand, J., & Sjöström, L.
- Affiliations
- Sahlgrenska University Hospital (SE)
- Aarhus University Hospital (DK)
- Corresponding author
- Karason, Kristjan
- ORCID
- Karason, Kristjan
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 1999-04
- Volume
- 83
- Issue
- 8
- Pages
- 1242-1247
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W2086229307
- Cited by
- 402
- References
- 31
- Citations by year
- 2026: 13 · 2025: 12 · 2024: 4 · 2023: 10 · 2022: 15 · 2021: 14 · 2020: 19 · 2019: 23 · 2018: 25 · 2017: 19 · 2016: 24 · 2015: 28 · 2014: 23 · 2013: 17 · 2012: 24
- FWCI
- 4.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American 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 › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Keywords
- heart rate variability, obesity, weight loss, cardiac autonomic function, sympathetic activity, parasympathetic activity, blood pressure, urinary norepinephrine, bariatric surgery, dietary weight loss, SDANN
- MeSH terms
- Adult, Blood Pressure, Circadian Rhythm, Diet, Female, Follow-Up Studies, Heart Rate, Humans, Male, Middle Aged, Norepinephrine, Obesity, Risk Factors, Gastroplasty, Weight Loss, Electrocardiography, Ambulatory, Body Mass Index
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