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. 2025 Jan 16:zwaf011.
doi: 10.1093/eurjpc/zwaf011. Online ahead of print.

Autonomic cardiac control independently predicts incident hypertension and systolic blood pressure in a multi-ethnic population: The HELIUS study

T A Bouwmeester  1   2 , E M C Vriend  1   2 , H Galenkamp  2 , B E Westerhof  3   4 , D Collard  1   2 , B J H van den Born  1   2
Affiliations

Autonomic cardiac control independently predicts incident hypertension and systolic blood pressure in a multi-ethnic population: The HELIUS study

T A Bouwmeester et al. Eur J Prev Cardiol. .

Abstract

Aims: Cross-correlation baroreflex sensitivity (xBRS) and heart rate variability (HRV) are measures of autonomic cardiac control and are associated with hypertension. However, their value in predicting new-onset hypertension and changes in systolic blood pressure (SBP) remains elusive.

Methods: We used longitudinal data of participants with- and without a history of cardiovascular disease from the HEalthy Life In an Urban Setting (HELIUS) study. A non-invasive continuous finger blood pressure measurement at baseline was used to calculate xBRS and HRV. In normotensives at baseline we calculated the odds ratio (OR) of developing hypertension at follow-up. In the full cohort we assessed the change in SBP between baseline and follow-up using linear regression. Subgroup analyses were performed in the younger (<50 years) and older (≥50 years) participants.

Results: Median follow-up was 6.6 years (IQR 5.8-7.4). A 50% lower xBRS at baseline was independently associated with a 1.31 higher OR (95% CI 1.09-1.57) of developing hypertension at follow-up. No significant associations between the standard deviation normal-to-normal interval (SDNN) or the root mean square of differences in successive normal-to-normal interval (RMSDD), and new-onset hypertension were found. Compared to the lowest tertile, an xBRS in the highest tertile was associated with a 3.61 mmHg (95%CI 2.50-4.71) higher increase in SBP over time, whereas this was 1.11 mmHg (95%CI 0.12-2.09) and 1.76 mmHg (95%CI 0.73-2.79) for SDNN and RMSDD.

Conclusion: In the general population, a lower xBRS is associated with increased odds of developing hypertension, and a steeper increase in SBP over time.

Keywords: HELIUS; cross-correlation baroreflex sensitivity; heart rate variability; hypertension; systolic blood pressure.

Plain language summary

Cross-correlation baroreflex sensitivity (xBRS) and heart rate variability (HRV) are associated with cardiac autonomic function, and they predict blood pressure increases in a multi-ethnic population, whereas only xBRS additionally predicts new-onset hypertension in normotensives. The prognostic value of xBRS on new-onset hypertension has not been investigated yet. We show that xBRS independently predicts new-onset hypertension, and both xBRS and heart rate variability HRV predict blood pressure increases in a large heterogenous cohort.Our findings may hold promise for the development of wearable devices where non-invasive assessment of xBRS can be implemented.

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  • Baroreflex: ready for prime-time?
    Lantelme P, Debouzy-Berge C, Courand PY. Lantelme P, et al. Eur J Prev Cardiol. 2025 Feb 18:zwaf079. doi: 10.1093/eurjpc/zwaf079. Online ahead of print. Eur J Prev Cardiol. 2025. PMID: 39963717 No abstract available.

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