Which Components of the Haemodynamic Response to Active Stand Predict Cardiovascular Disease and Mortality? Data From
Insights
Analyzing heart rate and blood pressure responses during standing reveals distinct links to cardiovascular disease and mortality. These integrated haemodynamic markers offer insights into neuro-cardiovascular health.
Area of Science:
- Cardiology
- Neuroscience
- Public Health
Background:
- The integrated haemodynamic response during standing (active stand - AS) may indicate neuro-cardiovascular function.
- Heart rate (HR) and blood pressure (BP) responses during AS are individually linked to cardiovascular disease (CVD) and mortality.
- Longitudinal associations between entire HR/BP response curves during AS, incident CVD, and mortality were assessed over 12 years.
Purpose of the Study:
- To assess longitudinal associations between complete HR/BP response curves during AS and incident CVD and mortality.
- To investigate if integrating entire haemodynamic response curves during AS provides novel insights into CVD and mortality risk.
- To establish AS as a potential integrative marker of neuro-cardiovascular health.
Main Methods:
- Beat-to-beat dynamic HR/BP measurements during AS in 4,336 individuals (61.5±8.2 years).
- Functional Principal Components Analysis (FPCA) applied to HR/BP response curves.
- Association analysis between FPCA-derived HR/BP curve components and 12-year incident CVD and mortality.
Main Results:
- Higher pre-AS systolic BP (SBP) and blunted SBP recovery during AS were linked to increased all-cause mortality (HR: 1.14).
- Higher baseline/peak HR and lower post-30s HR were associated with lower circulatory mortality (HR: 0.78).
- Elevated HR throughout AS correlated with higher mortality from other causes (HR: 1.48).
Conclusions:
- Distinct relationships exist between HR/BP responses during AS and 12-year CVD incidence and mortality.
- Integrating the full haemodynamic response curve during AS offers a more nuanced understanding of cardiovascular risk.
- AS haemodynamic responses may serve as a valuable integrative marker for neuro-cardiovascular health in middle-aged and older adults.
Background:
An integrated haemodynamic response during standing may serve as an integrative marker of neuro-cardiovascular function. Individual components of both heart rate (HR) and blood pressure (BP) responses to active stand (AS) have been linked with cardiovascular disease (CVD) and mortality. We assessed longitudinal associations between entire HR/BP response curves during AS, incident CVD and mortality over 12 years.
Methods:
Beat-to-beat measurements of dynamic HR/BP responses to AS were conducted in 4,336 individuals (61.5±8.2 years; 53.7% female). Functional Principal Components Analysis was applied to HR/BP response curves and their association with CVD and mortality assessed. We hypothesised that integrating BP/HR information from the entire haemodynamic response curve may uncover novel associations with both CVD and mortality.
Results:
Higher systolic BP (SBP) before AS and blunted recovery of SBP during AS was associated with all-cause mortality over 12-years (Hazard Ratio [HR]: 1.14; 1.04, 1.26; p=0.007). Higher baseline/peak HR and lower HR from 30 seconds post stand onwards were associated with lower mortality due to circulatory causes (HR: 0.78; 0.64, 0.95; p = 0.013). Higher HR throughout AS was associated with mortality from other causes (HR: 1.48; 1.22, 1.80; p<0.001). Findings persisted on robust covariate adjustment.
Conclusions:
We observed distinct relationships between HR/BP responses to AS and 12-year incident CVD and mortality. Integrating the entire haemodynamic response may reveal more nuanced relationships between HR/BP responses to AS, CVD and mortality - serving as an integrative marker of neuro-cardiovascular health in midlife and beyond.
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