Heart Rate Variability and Cognitive Function in Middle-Age Adults: The Coronary Artery Risk Development in Young Adults

Adina Zeki Al Hazzouri*, Tali Elfassy, Mercedes R. Carnethon, Donald M. Lloyd-Jones, Kristine Yaffe

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

44 Scopus citations

Abstract

BACKGROUND Low heart rate variability (HRV), a marker of cardiac autonomic dysfunction, has been associated with major risk factors of cognitive impairment. Yet, the direct association of HRV with cognitive function remains relatively unexplored, particularly in midlife. METHODS In 2005, 2 measures of short-term HRV, the SD of normal-to-normal intervals (SDNN) and the root mean square of successive differences (RMSSD), were calculated for participants of the Coronary Artery Risk Development in Young Adults study, and then categorized into quartiles. Five years later, 3 cognitive tests were administered for verbal memory ("Rey Auditory-Verbal Learning Test", RAVLT, range 0-15), processing speed ("Digit Symbol Substitution Test", DSST, range 0-133), and executive function ("Stroop interference"). RESULTS Two thousand one hundred and eighteen participants (57.7% female, 42.2% Black) with a mean baseline age of 45.3 years were included in this analysis. In demographic-adjusted models, compared to participants with quartile 1 SDNN (lowest quartile), participants in the upper quartiles of SDNN scored better on the DSST (quartile 4: β = 1.83 points better, P = 0.03; and quartile 3: β = 1.95 points better, P = 0.03) and on the stroop (quartile 3: β = 1.19 points better, P < 0.05; and quartile2: β = 1.44 points better, P = 0.02). After adjusting for behavioral and cardiovascular risk factors, higher quartile SDNN remained significantly associated with better stroop score (quartile 3: β = 1.21 points better, P = 0.04; and quartile 2: β = 1.72 points better, P < 0.01) but not with DSST. There was no association between quartile of RMSSD and cognitive function, from fully adjusted models. CONCLUSIONS Our findings suggest that higher quartile SDDN is associated with better executive function in midlife, above, and beyond cardiovascular risk factors.

Original languageEnglish (US)
Pages (from-to)27-34
Number of pages8
JournalAmerican Journal of Hypertension
Volume31
Issue number1
DOIs
StatePublished - Jan 1 2018

Funding

Dr. Zeki Al Hazzouri was supported by a grant from the National Institutes of Health, National Institute on Aging (K01AG047273). Dr. Yaffe was supported by a grant from the NIH/NIA (k24AG031155). Dr. Elfassy was supported by a T32 training grant from the National Institutes of Health, National Heart, Lung, and Blood Institute (HL 007426) and an American Heart Association postdoctoral fellowship (17POST32490000). The Coronary Artery Risk Development in Young Adults Study (CARDIA) is supported by contracts HHSN268201300025C, HHSN268201300026C, HHSN268201300027C, HHSN268201300028C, HHSN268201300029C, and HHSN268200900041C from the National Heart, Lung, and Blood Institute (NHLBI), the Intramural Research Program of the National Institute on Aging (NIA), and an intra-agency agreement between NIA and NHLBI (AG0005). The sponsors had no role in the study design; collection, analysis, and interpretation of the data; writing the report; and the decision to submit the report for publication. Dr. Zeki had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Keywords

  • Aging
  • autonomic function
  • blood pressure
  • cognition
  • epidemiology
  • heart rate variability
  • hypertension

ASJC Scopus subject areas

  • Internal Medicine

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