Key result
Low heart rate variability, defined as an SDNN ≤ 30, significantly increased the 8-year risk of cardiovascular disease by 87% (HR 1.87) in professional bus drivers without prior CVD.
Why the study?
Professional drivers have occupational characteristics that increase CVD risk, making early monitoring important to devise workplace preventive measures.
Does reduced 5-minute resting heart rate variability predict an increased 8-year risk of cardiovascular disease in professional bus drivers?
Cohort (n=788)
Does reduced 5-minute resting heart rate variability predict an increased 8-year risk of cardiovascular disease in professional bus drivers?
Effect estimate: HR 1.87 (95% CI 1.11-3.13)
p-value: p=0.018
A 5-minute resting heart rate variability test can independently predict the 8-year risk of cardiovascular disease, particularly hypertensive disease, in professional drivers.
Reduced HRV was associated with higher CVD risk in bus drivers; leaves open whether screening improves outcomes in occupational cohorts.
Background: Characteristics of professional drivers like irregular work shifts, long hours of driving, sedentary restricted postures, long-term sleep deficiency, increase the probability of developing cardiovascular disease (CVD). Therefore, early monitoring CVD risk is important to device preventive measures in the workplace. Objective: This cohort study used to evaluate the effectiveness of noninvasive heart rate variability (HRV) analysis to assess the 8-year risk of CVD events. Methods: Personal and working characteristics were collected before biochemistry examinations and 5-min HRV tests from Taiwan Bus Driver Cohort Study (TBDCS) in 2005. Then, this cohort was linked to Taiwan’s National Health Insurance Research Database (NHIRD) to obtain subjects’ medical information. This study eventually identified 161 drivers with CVD and 627 without from 2005 to 2012. Cox proportional hazards model were performed to estimate the hazard ratio for CVD. Results: Subjects with overall CVD had lower the standard deviation of NN intervals (SDNN) than their counterparts. Even after adjusting for risk factors, SDNN index have a strong association with overall CVD. Using median split for SDNN, hazard ratio of overall CVD was 1.83 (95% CI 1.10–3.04) in model 1 and 1.87 (95% CI 1.11–3.13) in model 2. Furthermore, Low frequency (LF) index associated with risk of overall CVD in the continuous approach. For hypertensive disease, the SDNN index was associated with increased risks in both the continuous and dichotomized approaches. When Root Mean Square of the Successive Differences (RMSSD), high frequency (HF), and LF as a continuous variable, the significant association with hypertensive disease were observed. Conclusions: This cohort study suggests that SDNN and LF levels are useful for predicting 8-year CVD risk, especially for hypertensive disease. Further research is required to determine preventive measures for modifying HRV dysfunction as well as to investigate whether these interventions could reduce CVD risk in professional drivers.
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Wang et al. (2020) conducted a cohort in Cardiovascular disease (n=788). Low heart rate variability (SDNN ≤ 30) vs. Normal/high heart rate variability (SDNN > 30) was evaluated on Incident cardiovascular disease (HR 1.87, 95% CI 1.11-3.13, p=0.018). Low heart rate variability, defined as an SDNN ≤ 30, significantly increased the 8-year risk of cardiovascular disease by 87% (HR 1.87) in professional bus drivers without prior CVD.
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