NDLI: Decreased nighttime heart rate variability is associated with increased stroke risk.

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Decreased nighttime heart rate variability is associated with increased stroke risk.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Binici, Zeynep Mouridsen, Mette Rauhe Køber, Lars Sajadieh, Ahmad
Description	Country affiliation: Denmark Author Affiliation: Binici Z ( Department of Cardiology, Copenhagen University Hospital of Amager, Denmark. zeynep.binici@dadlnet.dk)
Abstract	BACKGROUND AND PURPOSE: Prediction of stroke in healthy individuals is challenging and there is a diurnal variation of stroke onset. We hypothesized that heart rate variability with a focus on nighttime heart rate variability will predict the risk of stroke in apparently healthy middle-age and elderly subjects. METHODS: The population-based cohort of the Copenhagen Holter Study, consisting of 678 healthy subjects between age 55 and 75 years with no history of cardiovascular disease or stroke, was evaluated. All underwent 48-hour ambulatory electrocardiogram monitoring. The SD of normal-to-normal RR intervals (SDNN) was selected as the method of measuring heart rate variability. Nighttime SDNN was measured between 02:00 and 02:15 AM and could be evaluated in 653 subjects. Median follow-up was 76 months. RESULTS: Nighttime SDNN was lower in women than in men (P=0.0008), and in diabetics than nondiabetics (P=0.03). However, smoking, cholesterol, systolic blood pressure, and age were not associated with nighttime SDNN. The risk of stroke was significantly associated with nighttime SDNN in a univariate analysis (HR, 0.66; 95% CI, 0.50-0.88; P=0.004) and after adjustment for conventional risk factors (HR, 0.67; 95% CI, 0.51-0.89; P=0.005) per 10 ms increments of SDNN. Eighty-one percent of all strokes (21/26) occurred in 330 subjects with the lower half of nighttime SDNN (≤38 ms; HR, 4.31; 95% CI, 1.62-11.42; P=0.003). CONCLUSIONS: Nocturnal heart rate variability is a strong marker for the development of stroke in apparently healthy subjects. The mechanism is unknown, but reduced parasympathetic activity may increase the risk of stroke by increasing the risk of arrhythmias.
ISSN	00392499
e-ISSN	15244628
Journal	Stroke
Issue Number	11
Volume Number	42
Language	English
Publisher	Lippincott Williams & Wilkins (on behalf of the American Heart Association)
Publisher Date	2011-11-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Circadian Rhythm Physiology Electrocardiography, Ambulatory Heart Rate Stroke Physiopathology Cohort Studies Risk Factors Sleep Stages Etiology Comparative Study Research Support, Non-u.s. Gov't Discipline Cardiology
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine Neuroscience Advanced and Specialized Nursing Neurology (clinical)

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