Link Between Elevated Long-Term Resting Heart Rate Variability and Pulse Pressure Variability for All-Cause Mortality

Area of Science:

• Cardiovascular Health
• Mortality Risk Factors
• Clinical Epidemiology

Background:

• Elevated long-term systolic blood pressure and resting heart rate variability are linked to increased all-cause mortality (ACM).
• The specific relationship between resting heart rate (RHR) and pulse pressure variability and ACM risk was not fully understood.

Purpose of the Study:

• To investigate the association between long-term resting heart rate (RHR) and pulse pressure variability and all-cause mortality (ACM).

Main Methods:

• Analysis of 46,751 individuals from the Kailuan Cohort Study.
• Utilized Cox regression and Kaplan-Meier analyses to assess mortality risk.
• Stratified survival analysis based on quartiles of RHR and pulse pressure variability measures (SD, coefficient of variation, average real variability).

Main Results:

• For individuals under 65, higher pulse pressure variability (3rd and 4th quartiles) was independently associated with increased ACM risk.
• For individuals over 65, higher RHR variability (2nd, 3rd, and 4th quartiles) showed a dose-dependent increase in ACM risk.
• Specific hazard ratios indicated significant risk increases for elevated variability in both measures, particularly in older age groups.

Conclusions:

• Elevated long-term RHR variability and increased pulse pressure variability are significant independent risk factors for ACM.
• The combined effect of elevated variability in both RHR and pulse pressure amplifies ACM risk.
• These findings highlight the importance of monitoring both RHR and pulse pressure variability for assessing mortality risk.