Cardiovascular autonomic dysfunction precedes cardiovascular disease and all‐cause mortality: 11‐year follow‐up in the ADDITION ‐ PRO study
Authors' conclusion
Cardiovascular autonomic dysfunction, measured by multiday HRV, is linked with MACE, heart failure and all-cause mortality. Certain time frames of the day for HRV and heart rate under free-living conditions showed a higher risk of cardiovascular disease.
Study context
- Population
- People at high risk of diabetes, ADDITION-PRO study; Heart rate variability (HRV) measured 2009–2011; mean (SD) age 66 years (7), 47% women
- Participants
- 1,627 people
- Exposure
- Multiday HRV per SD
- Outcome
- MACE (MI, stroke, cardiovascular death), HF and all-cause mortality
- Follow-up
- Until 2021
Methodological detailssecondary analysis of the ADDITION-PRO study, registry-linked follow-up, Poisson regression
- Secondary analysis of the ADDITION-PRO study
- Registry-linked follow-up
- Poisson regression
Main finding
As reported in the abstract
MACE, HF and all-cause mortality per SD multiday SDNN
Major adverse cardiovascular events (MACE): IRR per SD SDNN
0.82
CI: 0.69; 0.97
HF: IRR per SD SDNN
0.76
CI: 0.58; 0.99
All-cause mortality: IRR per SD SDNN
0.79
CI: 0.66; 0.94
Observational data: associations, not effects.
Further findings
Multiday SDNN in the population
- Mean (SD) multiday SDNN, ms (SD 32.3)
- 139.0
Hourly SDNN
- SDNN 6:00–7:00 AM showed the strongest association with MACE risk
- Lower SDNN associated with all-cause mortality across all hours of the day
Original publication
Cardiovascular autonomic dysfunction precedes cardiovascular disease and all‐cause mortality: 11‐year follow‐up in the ADDITION ‐ PRO study. Diabetes Obes Metab. Published 9 July 2025. doi:10.
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