scholarly journals Exploring the relationship between schizophrenia and cardiovascular disease: A genetic correlation and multivariable Mendelian randomization study

2021 ◽  
Author(s):  
Rada R Veeneman ◽  
Jentien M Vermeulen ◽  
Abdel Abdellaoui ◽  
Eleanor Sanderson ◽  
Robyn E Wootton ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Diastolic Blood Pressure ◽  
Mendelian Randomization ◽  
Genetic Correlations ◽  
Lipid Levels ◽  
Early Repolarization ◽  
Artery Disease

Importance: Individuals with schizophrenia have a reduced life-expectancy compared to the general population, largely due to an increased risk of cardiovascular disease (CVD). Clinical and epidemiological studies have been unable to fully unravel the nature of this relationship. Objective: Investigate genetic correlations and potential bi-directional effects between liability to schizophrenia and CVD. Design, setting, and participants: We obtained summary-data of genome-wide-association studies of schizophrenia (N=130,644), heart failure (N=977,323), coronary artery disease (N=332,477), systolic and diastolic blood pressure (N=757,601), heart rate variability (N=46,952), QT interval (N=103,331), early repolarization and dilated cardiomyopathy ECG patterns (N=63,700). We computed genetic correlations with linkage disequilibrium score regression and conducted bi-directional Mendelian randomization (MR). With multivariable MR, we investigated whether associations were mediated by smoking, body mass index, physical activity, lipid levels, or type 2 diabetes. To ensure robustness, we applied a range of sensitivity methods. Main outcomes and measures: Schizophrenia, heart failure, coronary artery disease, systolic blood pressure, diastolic blood pressure, heart rate variability, QT interval, early repolarization, dilated cardiomyopathy. Results: Genetic correlations between liability to schizophrenia and CVD were close to zero (-0.02 to 0.04). With MR, we found robust evidence that liability to schizophrenia increases heart failure risk. This effect remained consistent with multivariable MR. There was also evidence that liability to schizophrenia increases early repolarization risk, largely mediated by BMI and lipid levels. Finally, there was evidence that liability to schizophrenia increases heart rate variability, a direction of effect contrasting previous studies. In the other direction, there was weak evidence that higher systolic, but not diastolic, blood pressure increases schizophrenia risk. Conclusions and relevance: Our findings indicate that liability to schizophrenia increases the risk of heart failure, and that this is not mediated by key health behaviours. This is consistent with the notion that schizophrenia is characterised by a systemic dysregulation of the body (including inflammation and oxidative stress) with detrimental effects on the heart. To decrease cardiovascular mortality among schizophrenia patients, priority should lie with optimal treatment and interventions in early stages of psychoses. We also identified early repolarization, currently understudied, as a potential CVD marker among patients with schizophrenia.

scholarly journals Melatonin for nondippers with coronary artery disease: assessment of blood pressure profile and heart rate variability

2009 ◽  
Vol 33 (1) ◽  
pp. 56-61 ◽  
Author(s):  
Tomasz Rechciński ◽  
Ewa Trzos ◽  
Karina Wierzbowska-Drabik ◽  
Maria Krzemińska-Pakuła ◽  
Małgorzata Kurpesa
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Coronary Artery ◽  
Pressure Profile ◽  
Disease Assessment ◽  
Blood Pressure Profile ◽  
Artery Disease

scholarly journals A pilot study investigating the relationship between heart rate variability and blood pressure in young adults at risk for cardiovascular disease

2022 ◽  
Vol 28 (1) ◽  
Author(s):  
Linda P. Bolin ◽  
Amelia D. Saul ◽  
Lauren L. Bethune Scroggs ◽  
Carolyn Horne
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Pilot Study ◽  
Family History ◽  
Diastolic Blood Pressure ◽  
Biofeedback Training ◽  
Paced Breathing ◽  
History Of

Abstract Background Cardiovascular disease is one of the leading causes of death globally with hypertension being a primary cause of premature death from this disease process. Individuals with a family history of cardiovascular disease and hypertension are at a greater risk for developing the same sequela. Autonomic cardiac control is important in the level of cardiac function. One intervention that is effective in improving cardiovascular function is heart rate variability biofeedback training. The purpose of our study was to determine the effectiveness of heart rate biofeedback training on HRV and blood pressure in individuals with a family history of cardiovascular disease. Methods Thirty-four participants (76.5% female, 22.7 ± 4.3 years) completed a baseline assessment and training using an established short-term HRV protocol followed by two weeks of at-home paced breathing employing a smartphone application. The participants were then reassessed in a biofeedback clinic. Results The participants physiological measures showed a significant increase in means between pre and post intervention of SDNN (t (32) = 2.177, p =.037) and TP, (t (32) = 2.327 p = .026). Correlation noted a medium effect on diastolic blood pressure and high frequency heart rate variability, F, r = .41, n =33, p < .05. A multiple regression with all predictor variables in the model found no significance with diastolic and systolic blood pressure. Conclusions The findings from this pilot study demonstrated that a two-week paced breathing intervention may assist in reducing heart rate and diastolic blood pressure while improving heart rate variability.

Fractal Component of Variability of Heart Rate and Systolic Blood Pressure in Congestive Heart Failure

1997 ◽  
Vol 92 (6) ◽  
pp. 543-550 ◽  
Author(s):  
Gary C. Butler ◽  
Shin-Ichi Ando ◽  
John S. Floras
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Systolic Blood Pressure ◽  
Spectral Power ◽  
Normal Subjects ◽  
Total Spectral Power ◽  
Systolic Blood Pressure Variability ◽  
Harmonic Components

1. There is a substantial non-harmonic or fractal component to the variability of both heart rate and blood pressure in normal subjects. Heart rate is the more complex of these two signals, with respect to the slope, β, of the 1/fβ relationship. In congestive heart failure, heart rate spectral power is attenuated, but the fractal and harmonic components of heart rate and systolic blood pressure variability have not been characterized. 2. Two groups, each comprising 20 men, were studied during 15 min of supine rest and spontaneous respiration: one with functional class II—IV heart failure (age 52 ± 2 years; mean ± SEM) and a second group of healthy men (age 46 ± 2 years). 3. Total spectral power for heart rate was significantly reduced in heart failure (P < 0.02), whereas total spectral power for systolic blood pressure was similar in the two groups. In both heart failure and normal subjects, 65–80% of total spectral power in these two signals displayed fractal characteristics. 4. In heart failure, the slope of the 1/fβ relationship for heart rate was significantly steeper than in normal subjects (1.40 ± 0.08 compared with 1.14 ± 0.05; P < 0.05), indicating reduced complexity of the fractal component of heart rate variability. There was no significant difference in the 1/fβ slope for systolic blood pressure variability between these two groups, but the blood pressure signals were less complex than heart rate variations in both heart failure (2.31 ± 0.15; P < 0.006) and normal subjects (2.47 ± 0.15; P < 0.0001). 5. Parasympathetic nervous system activity, as estimated from heart rate variability was reduced (P < 0.01) in patients with heart failure, whereas trends towards increased sympathetic nervous system activity and decreased non-harmonic power were not significant. 6. The non-harmonic components of cardiac frequency are reduced in heart failure. Non-harmonic power is not attenuated, but the complexity of the heart rate signal is less than in subjects with normal ventricular function. A reduction in parasympathetic modulation appears to contribute to this loss of complexity of heart rate. Consequently, the heart rate signal comes to resemble that of blood pressure. In contrast, the variability and complexity of the systolic blood pressure signal is similar in heart failure and normal subjects. This reduced complexity of heart rate variability may have adverse implications for patients with heart failure.

scholarly journals Heritability and the Genetic Correlation of Heart Rate Variability and Blood Pressure in >29 000 Families

Hypertension ◽  
2020 ◽  
Vol 76 (4) ◽  
pp. 1256-1262
Author(s):  
Balewgizie S. Tegegne ◽  
Tengfei Man ◽  
Arie M. van Roon ◽  
Nigus G. Asefa ◽  
Harriëtte Riese ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Genetic Correlation ◽  
Root Mean Square ◽  
Genome Wide Association Study ◽  
Genetic Correlations ◽  
Substantial Contribution ◽  
Mean Square ◽  
Cardiac Autonomic Nervous System

Dysregulation of the cardiac autonomic nervous system, as indexed by reduced heart rate variability (HRV), has been associated with the development of high blood pressure (BP). However, the underlying pathological mechanisms are not yet fully understood. This study aimed to estimate heritability of HRV and BP and to determine their genetic overlap. We used baseline data of the 3-generation Lifelines population-based cohort study (n=149 067; mean age, 44.5). In-house software was used to calculate root mean square of successive differences and SD of normal-to-normal intervals as indices of HRV based on 10-second resting ECGs. BP was recorded with an automatic BP monitor. We estimated heritabilities and genetic correlations with variance components methods in ASReml software. We additionally estimated genetic correlations with bivariate linkage disequilibrium score regression using publicly available genome-wide association study data. The heritability (SE) estimates were 15.6% (0.90%) for SD of normal-to-normal intervals and 17.9% (0.90%) for root mean square of successive differences. For BP measures, they ranged from 24.4% (0.90%) for pulse pressure to 30.3% (0.90%) for diastolic BP. Significant negative genetic correlations (all P <0.0001) of root mean square of successive differences/SD of normal-to-normal intervals with systolic BP (−0.20/−0.16) and with diastolic BP (−0.15/−0.13) were observed. LD score regression showed largely consistent genetic correlation estimates of root mean square of successive differences/SD of normal-to-normal intervals with systolic BP (range, −0.08 to −0.23) and diastolic BP (range, −0.20 to −0.27). Our study shows a substantial contribution of genetic factors in explaining the variance of HRV and BP measures in the general population. The significant negative genetic correlations between HRV and BP indicate that genetic pathways for HRV and BP partially overlap.

scholarly journals Heart Rate Variability and Risk of All-Cause Death and Cardiovascular Events in Patients With Cardiovascular Disease: A Meta-Analysis of Cohort Studies

2019 ◽  
Vol 22 (1) ◽  
pp. 45-56 ◽  
Author(s):  
Su-Chen Fang ◽  
Yu-Lin Wu ◽  
Pei-Shan Tsai
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cohort Studies ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Coronary Syndrome ◽  
Artery Disease

Lower heart rate variability (HRV) is associated with a higher risk of cardiovascular events and mortality, although the extent of the association is uncertain. We performed a meta-analysis of cohort studies to elucidate the association between HRV and the risk of all-cause death or cardiovascular events in patients with cardiovascular disease (CVD) during a follow-up of at least 1 year. We searched four databases (PubMed, MEDLINE, Embase, and Cochrane Central Register of Controlled Trials) and extracted the adjusted hazard ratio (HR) from eligible studies. We included 28 cohort studies involving 3,094 participants in the meta-analysis. Results revealed that lower HRV was associated with a higher risk of all-cause death and cardiovascular events; the pooled HRs were 2.12 (95% confidence interval [CI] = [1.64, 2.75]) and 1.46 (95% CI [1.19, 1.77]), respectively. In subgroup analyses, the pooled HR of all-cause death was significant for patients with acute myocardial infarction (AMI) but not for those with heart failure. The pooled HR for cardiovascular events was significant for the subgroup of patients with AMI and acute coronary syndrome but not for those with coronary artery disease and heart failure. Additionally, both time and frequency domains of HRV were significantly associated with risk of all-cause death and cardiovascular events in patients with CVD.

Abstract 15209: Effects of Coffee Consumption on Exercise Tolerance, Blood Pressure, Heart Rate, Heart Rate Variability and Premature Beats in Volunteers with Coronary Artery Disease

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Bruno M Mioto ◽  
Miguel A Moretti ◽  
Daniela Tarasoutchi ◽  
Reynaldo V Amato ◽  
Dante M Giorgi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Exercise Tolerance ◽  
Treadmill Test ◽  
Holter Ecg ◽  
Artery Disease ◽  
Premature Beats ◽  
Filtered Coffee

Introduction: Coffee is supposed to increase blood pressure (BP) and heart rate (HR), which may be deleterious for patients with coronary artery disease (CAD). However a review of the literature reveals few studies evaluating these effects in patients with CAD. Objective: The aim of this study was to compare the effects of dark roast (DR) and medium dark roast (MDR) paper-filtered coffee on BP, exercise tolerance, HR, heart rate variability (HRV) and extrasystoles in volunteers with CAD. Methods: This randomized crossed-over trial compared the effects of consuming three or four cups (150 mL) of DR and MDR coffee per day for 4 weeks in 40 volunteers with CAD. In the baseline and after each 4 weeks period of drinking they were submitted to treadmill test, ambulatory blood pressure monitoring (24-h ABPM) and 24-h Holter ECG. We analyzed average systolic BP (SBP) and diastolic BP (DBP) at 24-h ABPM, total exercise time ([[Unable to Display Character: &#8710;]]T Exercise) and double product (DP) at treadmill test, and average HR, SDNN, ventricular (VPB) and supraventricular premature beats (SPB) at 24-h Holter ECG. Variables were evaluated by ANOVA for repeated measures and Friedman test when indicated. Results: We evaluated 40 subjects with CAD, 64.7 ± 6.7 years old, 32 men. All volunteers received adequate treatment for CAD according to the guidelines. Compared with baseline, subjects had an increase of 6.4% and 5.7% in [[Unable to Display Character: &#8710;]]T exercise at treadmill test after MDR and DR consumption respectively [565.8 ± 194.8 vs 601.8 ± 212.9 vs 597.8 ± 208.0 s (p=0.001)] without an increase in DP (p=0.91). In the 24-h Holter ECG at baseline, DR and MDR the following values were obtained, respectively: HR [67.1 ± 8.6 vs 66.5 ± 8.2 vs 67.2 ± 8.5 (p=0.71)], SDNN [130.6 ± 32.7 vs 134.2 ± 30.6 vs 129.7 ± 28.5 (p=0.428)], VPB [8.0 (2.0-395.5) vs 9.5 (0.2-54.7) vs 11.5 (3.0-51.7) (p=0.16)] and SPB [18.0 (5.2-73.0) vs 20.0 (5.5-75.5) vs 16.5 (6.2-72.5) (p=0.52)]. In the 24-h ABPM at baseline, DR and MDR the following values were obtained, respectively: SBP [110.8 ± 9.1 vs 109.2 ± 19.9 vs 114.7 ± 11.8 mmHg (p=0.10)] and DBP [64.1 ± 9.1 vs 64.6 ± 9.3 vs 66.4 ± 9.7 mmHg (p=0.14)]. Conclusions: Paper-filtered coffee increased exercise tolerance and had no considerable effect on BP, HR, HRV and premature beats in volunteers with CAD.

Effects of angiotensin II (AT1) receptor blockade on cardiac vagal control in heart failure

2001 ◽  
Vol 101 (6) ◽  
pp. 559-566 ◽  
Author(s):  
J. C. VAILE ◽  
S. CHOWDHARY ◽  
F. OSMAN ◽  
H. F. ROSS ◽  
J. FLETCHER ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Angiotensin Ii ◽  
Baroreflex Sensitivity ◽  
At1 Receptor ◽  
Receptor Blockade ◽  
Double Blind ◽  
Rr Interval

The objective of the present study was to determine the autonomic effects of angiotensin II (AT1) receptor blocker therapy in heart failure. In a randomized double-blind cross-over study, we compared the effects of candesartan and placebo on baroreflex sensitivity and on heart rate variability at rest, during stress and during 24h monitoring. Acute effects were assessed 4h after oral candesartan (8mg) and chronic effects after 4 weeks of treatment (dose titrated to 16mg daily). The study group comprised 21 patients with heart failure [mean (S.E.M.) ejection fraction 33% (1%)], in the absence of angiotensin-converting enzyme (ACE) inhibitor therapy. We found that acute candesartan was not different from placebo in its effects on blood pressure or mean RR interval. Chronic candesartan significantly reduced blood pressure [placebo, 137 (3)/82 (3)mmHg; candesartan, 121 (4)/75 (2)mmHg; P<0.001; values are mean (S.E.M.)], but had no effect on mean RR interval [placebo, 857 (25)ms; candesartan, 857 (21)ms]. Compared with placebo there were no significant effects of acute or chronic candesartan on heart rate variability in the time domain and no consistent effects in the frequency domain. Baroreflex sensitivity assessed by the phenylephrine bolus method was significantly increased after chronic candesartan [placebo, 3.5 (0.5)ms/mmHg; candesartan, 4.8 (0.7)ms/mmHg; P<0.05], although there were no changes in cross-spectral baroreflex sensitivity. Thus, in contrast with previous results with ACE inhibitors, angiotensin II receptor blockade in heart failure did not increase heart rate variability, and there was no consistent effect on baroreflex sensitivity.

Sign in / Sign up

Export Citation Format

Share Document