Maqsood, R., Schofield, S., Bennett, A. N., Khattab, A., Bull, A. M. J., Fear, N. T., Cullinan, P., Boos, C. J. and ADVANCE Study, 2025. The inverse and non-linear association between central augmentation index and heart rate variability in a cohort of male British combat personnel- findings from the ADVANCE study. Blood Pressure. (In Press)
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DOI: 10.1080/08037051.2025.2524409
Abstract
PURPOSE: The central augmentation index (cAIx) is an indirect measure of arterial stiffness. The influence of heart rate variability (HRV) on cAIx remains unexplored in a military cohort and was the aim of this analysis. METHOD: The first follow-up data from the ArmeD serVices trAuma rehabilitatioN outComE (ADVANCE) study were analysed. Participants were male British servicemen who served in Afghanistan (2003-2014) and were divided into two groups at recruitment: injured (who sustained severe combat injury) and uninjured. The uninjured were frequency-matched to the injured by age, rank, role-in-theatre and deployment. HRV was reported as root-mean-square-of-successive-differences (RMSSD) using a five-minute single-lead electrocardiogram. The cAIx was measured using pulse waveform analysis and was adjusted for heart rate at 60 beats/minute (cAIx@60). Effect modification by injury was assessed via interaction analysis. Linear models reported the association between RMSSD (HRV) and cAIx@60 adjusting for a priori confounders. RESULTS: 1052 participants (injured n = 526; uninjured 526; median age at follow-up 37.4 years) were examined. Effect modification by injury was not statistically significant; therefore, was adjusted for along with other confounders. RMSSD and cAIx@60 exhibited a moderate inverse correlation (-0.40; p < 0.001). The association between natural log-transformed RMSSD (LnRMSSD) and cAIx@60 was non-linear and statistically significant, suggesting that a 10% decrease in LnRMSSD would be associated with 0.30% increase in cAIx@60. CONCLUSION: Lower RMSSD (HRV) is associated with an increase in cAIx@60, independent of injury status and other traditional cardiovascular risk factors. The efficacy of positive HRV modification on cardiovascular risk in military populations needs to be examined.
Item Type: | Article |
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ISSN: | 0803-7051 |
Uncontrolled Keywords: | Arterial stiffness; HRV; Trauma; vagal tone. Military |
Group: | Faculty of Health & Social Sciences |
ID Code: | 41132 |
Deposited By: | Symplectic RT2 |
Deposited On: | 01 Jul 2025 09:18 |
Last Modified: | 01 Jul 2025 09:18 |
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