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Nocturnal Respiratory Rate and Variability Predict Long-term Mortality in Stable Outpatients with Cardiovascular
Medrxiv : the Preprint Server for Health Sciences
|June 29, 2026
Summary
Nocturnal respiratory rate (NRR) and its variability are key predictors of mortality in stable cardiovascular outpatients. Higher NRR levels and variability indicate increased risk, identifying a high-risk group with significantly higher mortality.
Area of Science:
- Cardiology
- Pulmonology
- Biomarkers
Background:
- Respiratory rate (RR) is a known short-term mortality predictor in acute care.
- Its prognostic value in stable outpatients with cardiovascular disease is not well-established.
Purpose of the Study:
- To investigate the association between median and variability of nocturnal respiratory rate (NRR) and long-term mortality.
- To determine if NRR is an independent predictor in cardiovascular outpatients.
Main Methods:
- Analysis of overnight polysomnography data from 5,679 cardiovascular disease patients in the Sleep Heart Health Study.
- Quantification of median NRR and within-night variability.
- Kaplan-Meier and Cox proportional hazards models for mortality prediction over 3 and 15 years.
Main Results:
- Higher median NRR and greater NRR variability were independently linked to increased cardiovascular and all-cause mortality.
- A high-risk group with high median and variability of NRR showed nearly five-fold higher 3-year all-cause mortality.
Conclusions:
- Baseline NRR level and variability are independent predictors of mortality in stable cardiovascular outpatients.
- NRR is a promising, underutilized biomarker for long-term risk stratification.
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