Temporal stability and drivers of change in cardiac autonomic nervous system activity.
OBJECTIVES
This study determined temporal stability of ambulatory measured cardiac autonomic activity for different time periods and investigated potential drivers of changes in this activity.


METHODS
Data was drawn from baseline (n=2379), 2-year (n=2245), and 6-year (n=1876) follow-up from the Netherlands Study of Depression and Anxiety. Cardiac autonomic activity was measured with heart rate (HR), respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP). Autonomic temporal stability was determined across 2, 4, and 6year intervals. We subsequently examined the association between sociodemographics, lifestyle, mental health, cardiometabolic health, and the use of antidepressant and cardiac medication with change in cardiac autonomic activity.


RESULTS
Over 2years, stability was good for HR (ICC=0.703), excellent for RSA (ICC=0.792) and moderate for PEP (ICC=0.576). Stability decreased for a 4- (HR ICC=0.688, RSA ICC=0.652 and PEP ICC=0.387) and 6-year interval (HR ICC=0.633, RSA ICC=0.654 and PEP ICC=0.355). The most important determinants for increase in HR were (increase in) smoking, increase in body mass index (BMI) and (starting) the use of antidepressants. Beta-blocking/antiarrhythmic drug use led to a decrease in HR. Decrease in RSA was associated with age, smoking and (starting) antidepressant use. Decrease in PEP was associated with age and (increase in) BMI.


CONCLUSIONS
Cardiac autonomic measures were rather stable over 2years, but stability decreased with increasing time span. Determinants contributing to cardiac autonomic deterioration were older age, (increase in) smoking and BMI, and (starting) the use of antidepressants. (Starting) the use of cardiac medication improved autonomic function.
['Hu|Mandy X|MX|', 'Lamers|Femke|F|', 'Penninx|Brenda W J H|BWJH|', 'de Geus|Eco J C|EJC|']
D000293:Adolescent D000328:Adult D000368:Aged D000928:Antidepressive Agents D001008:Anxiety Disorders D001341:Autonomic Nervous System D015992:Body Mass Index D002317:Cardiovascular Agents D003866:Depressive Disorder D005260:Female D005500:Follow-Up Studies D006321:Heart D006339:Heart Rate D006801:Humans D008137:Longitudinal Studies D008297:Male D008875:Middle Aged D009426:Netherlands D065809:Respiratory Sinus Arrhythmia D012907:Smoking D012959:Socioeconomic Factors D013997:Time Factors D055815:Young Adult
Temporal stability Autonomic nervous system Lifestyle Antidepressants Cardiac medication Longitudinal