Pulse rate variability predicted cardiovascular disease in sleep disordered breathing: The Guangdong sleep health study

Objectives: Pulse rate variability (PRV) predicts stroke in patients with sleep disordered breathing (SDB). However, the relationship between PRV and cardiovascular disease (CVD) was unknown in SDB. Methods: This was a cross-sectional study. Community residents in Guangdong were investigated. Sleep study were conducted with a type IV sleep monitoring. PRV parameters was assessed from the pulse waveforms derived from the sleep monitoring. Results: 3747 participants were enrolled. The mean age was 53.9 +/- 12.7 years. 1149 (30.7%) were diagnosed as SDB. PRV parameters, except for the averages of pulse-to-pulse intervals (ANN), were higher in participants with SDB than those without. After adjusting for traditional CVD risk factors, deceleration capacity of rate (DC), ANN, and the percentage of pulse-to-pulse interval differences that were more than 50 ms (PNN50) were correlated with CVD risk in participants with SDB (OR were 0.826, 1.002, and 1.285; P were 0.003, 0.009, and 0.010), but not in participants without SDB. There was no interaction effect between DC, ANN, PNN50 and oxygen desaturation index. In hierarchical analysis, DC and ANN were predictors for CVD in SDB patients with age <60 years, male, overweight, diabetes, and normal lipid metabolism. PNN50 was predictor for CVD in the elderly SDB patients without overweight, diabetes or dyslipidemia. Conclusions: PRV parameters may be specific predictors for CVD in SDB. PNN50 was a potent biomarker for CVD risk in the elderly with SDB, event without traditional CVD risk factors.

Automated summary

This study found that pulse rate variability (PRV) parameters can be specific predictors for cardiovascular disease (CVD) in patients with sleep disordered breathing (SDB). Particularly, for elderly SDB patients, pulse-to-pulse interval differences (PNN50) can serve as a potent biomarker for CVD risk, even without traditional CVD risk factors.