Abstract

Sympathovagal balance is important in the pathogenesis of hypertension and independently associated with mortality. We evaluated the value of automated analysis of cross-correlation baroreflex sensitivity (xBRS) and heart rate variability (HRV) and its relationship with clinical covariates in 13,326 participants from the multi-ethnic HELIUS study. Finger blood pressure (BP) was continuously recorded, from which xBRS, standard deviation of normal-to-normal intervals (SDNN), and squared root of mean squared successive difference between normal-to-normal intervals (RMSDD) were determined. A subset of?3356 recordings > 300?s was used to derive the minimally required duration by comparing shortened to complete recordings, defined as intraclass correlation (ICC) > 0.90. For xBRS and SDNN, 120?s and 180?s were required (ICC 0.93); for RMSDD, 60?s (ICC 0.94) was sufficient. We included 10,252 participants (median age 46?years, 54% women) with a recording > 180?s for the regression. xBRS, SDNN, and RMSDD decreased linearly up to 50?years?of age. For xBRS, there was a signification interaction with sex, with for every 10?years a decrease of 4.3?ms/mmHg (95%CI 4.0?4.6) for men and 5.9?ms/mmHg (95%CI 5.6?6.1) for women. Using splines, we observed sex-dependent nonlinearities in the relation with BP, waist-to-hip-ratio, and body mass index. Future studies can help unravel the dynamics of these relations and assess their predictive value. Graphical Abstract: Panel 1 depicts automatic analysis and filtering of finger BP recordings, panel 2 depicts computation of xBRS from interpolated beat to beat data of systolic BP and interbeat interval, and (IBI) SDNN and RMSDD are computed directly from the filtered IBI dataset. Panel 3 depicts the results of large-scale analysis and relation of xBRS with age, sex, blood pressure and body mass index. [Figure not available: see fulltext.].
Original languageEnglish
Pages (from-to)1183-1191
Number of pages9
JournalMedical and Biological Engineering and Computing
Volume61
Issue number5
Early online date2023
DOIs
Publication statusPublished - May 2023

Keywords

  • Algorithms
  • BRS
  • Cohort study
  • HRV
  • Sympathovagal balance

Cite this