title: Autonomic Imbalance as a Predictor of Metabolic Risks, Cardiovascular Disease, Diabetes, and Mortality.
abstract: BACKGROUND
  Identifying novel early predictors of metabolic disorders is essential to improving effective primary prevention.
  
  
  OBJECTIVE
  The objectives were to examine the contribution of two measures of autonomic imbalance, resting heart rate (RHR) and heart rate variability (HRV), on the development of five metabolic risk outcomes, and on cardiovascular disease, diabetes, and early mortality.
  
  
  METHODS
  This study was a secondary analysis of prospective data from Offspring Cohort participants (N = 1882) in the Framingham Heart Study (FHS).
  
  
  METHODS
  Participants at FHS Exam 3 (1983-1987) with 1) age years 18 or older, and 2) data on RHR, HRV, and five measures of metabolic risk (blood pressure, fasting glucose, triglycerides, high-density lipoprotein [HDL] cholesterol, and body mass index [BMI]) at three follow-up visits over 12 years. We conducted a backward elimination variable selection procedure on a logistic regression model, using baseline RHR, HRV, age, sex, and smoking status to predict the odds of developing a specific metabolic risk.
  
  
  RESULTS
  Measures included hyperglycemia, high blood pressure, high triglycerides, low HDL cholesterol, and high BMI over 12 years; incident diabetes, cardiovascular disease, and early mortality over 20 years.
  
  
  RESULTS
  RHR and HRV, along with sex, age, and smoking were significant predictors of high blood pressure, hyperglycemia, and a diagnosis of diabetes within 12 years. RHR and HRV also predicted the development of cardiovascular disease and early mortality for most of the sample.
  
  
  CONCLUSIONS
  In this community sample two measures of autonomic imbalance predicted multiple poor metabolic outcomes and mortality, making autonomic imbalance a potentially worthy target for intervention studies to reduce risks for cardiovascular disorders, diabetes, and early death.
authors.affiliation: Departments of Psychiatry (L.R.W., JL.P.) and Mathematics (P.S.H.), University of Cincinnati College of Medicine, Cincinnati VA Medical Center, Cincinnati, Ohio 45220; and Department of Biostatistics (J.M.M., R.B.D.), Boston University School of Public Health, and Department of Mathematics and Statistics (R.B.D.), Boston University, Boston, Massachusetts 02215.
authors.forename: Lawson R
authors.initials: LR
authors.lastname: Wulsin
authors.affiliation: Departments of Psychiatry (L.R.W., JL.P.) and Mathematics (P.S.H.), University of Cincinnati College of Medicine, Cincinnati VA Medical Center, Cincinnati, Ohio 45220; and Department of Biostatistics (J.M.M., R.B.D.), Boston University School of Public Health, and Department of Mathematics and Statistics (R.B.D.), Boston University, Boston, Massachusetts 02215.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Horn
authors.affiliation: Departments of Psychiatry (L.R.W., JL.P.) and Mathematics (P.S.H.), University of Cincinnati College of Medicine, Cincinnati VA Medical Center, Cincinnati, Ohio 45220; and Department of Biostatistics (J.M.M., R.B.D.), Boston University School of Public Health, and Department of Mathematics and Statistics (R.B.D.), Boston University, Boston, Massachusetts 02215.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Perry
authors.affiliation: Departments of Psychiatry (L.R.W., JL.P.) and Mathematics (P.S.H.), University of Cincinnati College of Medicine, Cincinnati VA Medical Center, Cincinnati, Ohio 45220; and Department of Biostatistics (J.M.M., R.B.D.), Boston University School of Public Health, and Department of Mathematics and Statistics (R.B.D.), Boston University, Boston, Massachusetts 02215.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Massaro
authors.affiliation: Departments of Psychiatry (L.R.W., JL.P.) and Mathematics (P.S.H.), University of Cincinnati College of Medicine, Cincinnati VA Medical Center, Cincinnati, Ohio 45220; and Department of Biostatistics (J.M.M., R.B.D.), Boston University School of Public Health, and Department of Mathematics and Statistics (R.B.D.), Boston University, Boston, Massachusetts 02215.
authors.forename: Ralph B
authors.initials: RB
authors.lastname: D'Agostino
mesh_terms: D000328:Adult; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000150:complications* / Q000401:mortality; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D008875:Middle Aged; D009026:Mortality; D011379:Prognosis; D012307:Risk Factors; D055815:Young Adult