Heart rate variability and risk of all-cause death and cardiovascular events in patients with cardiovascular disease: a meta-analysis of cohort studies
Abstract
Lower heart rate variability (HRV) is associated with a higher risk of cardiovascular events and mortality, although the extent of the association is uncertain. We performed a meta-analysis of cohort studies to elucidate the association between HRV and the risk of all-cause death or cardiovascular events in patients with cardiovascular disease (CVD) during a follow-up of at least 1 year. We searched four databases (PubMed, MEDLINE, Embase, and Cochrane Central Register of Controlled Trials) and extracted the adjusted hazard ratio (HR) from eligible studies. We included 28 cohort studies involving 3,094 participants in the meta-analysis. Results revealed that lower HRV was associated with a higher risk of all-cause death and cardiovascular events; the pooled HR was 2.27 (95% confidence interval [CI]: 1.72, 3.00) and 1.41 (95% CI: 1.16, 1.72), respectively. In subgroup analyses, the pooled HR of all-cause death was significant for patients with acute myocardial infarction (AMI) but not for those with heart failure. The pooled HR for cardiovascular events was significant for the subgroup of patients with AMI and acute coronary syndrome but not for those with coronary artery disease and heart failure. Additionally, both time and frequency domains of HRV were significantly associated with risk of all-cause death and cardiovascular events in patients with CVD.
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Low HRV is a marker of autonomic dysfunction associated with poor cardiovascular outcomes.
“with low HRV being a marker of autonomic dysfunction associated with poor cardiovascular outcomes”
From Exercise benefits in cardiovascular diseases: From mechanisms to clinical implementation (2023) · cites this paper as [186]
Regular PA/exercise increases heart rate variability (HRV) in both healthy individuals and in patients with CVD.
“Regular PA/exercise increases heart rate variability (HRV) -a measure of efferent PNS (vagal nerve) activity to the heart, with low HRV being a marker of autonomic dysfunction associated with poor cardiovascular outcomes-in both healthy individuals and in patients with CVD.186,187”
From Exercise benefits in cardiovascular diseases: From mechanisms to clinical implementation (2023) · cites this paper as [186]
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- Authors
- Fang, S.-C., Wu, Y.-L., & Tsai, P.-S.
- Affiliations
- Taipei Medical University (TW)
- Department of Nursing, St. Mary’s Junior College of Medicine, Nursing and Management, Yilan
- Taipei Medical University Hospital (TW)
- Corresponding author
- Tsai, Pei-Shan
- Venue
- Biological Research For Nursing
- Publisher
- SAGE Publications
- Published
- 2019-09-26
- Volume
- 22
- Issue
- 1
- Pages
- 45-56
- ISSN
- 1099-8004 (ISSN-L)
- 1552-4175
- OpenAlex
- W2976770731
- Cited by
- 302
- References
- 69
- Citations by year
- 2026: 42 · 2025: 61 · 2024: 67 · 2023: 52 · 2022: 39 · 2021: 27 · 2020: 13
- FWCI
- 3.58
- Type
- journal article
- Language
- en
- Update notices
- correction (2020-02-28)
- Open access
- closed
- Locations
- Biological Research For Nursing (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
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- heart rate variability, all-cause mortality, cardiovascular events, cardiovascular disease, acute myocardial infarction, acute coronary syndrome, heart failure, coronary artery disease, time-domain HRV, frequency-domain HRV
- MeSH terms
- Cardiovascular Diseases, Cause of Death, Heart Failure, Heart Rate, Humans, Myocardial Infarction, Cohort Studies, Stroke
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