Evidence mapPaperPMID 40635178Full record

ArticleDiabetes, obesity & metabolism2025

Cardiovascular autonomic dysfunction precedes cardiovascular disease and all-cause mortality: 11-year follow-up in the ADDITION-PRO study.

Jonas R Schaarup, Lasse Bjerg, Christian S Hansen, Erik L Grove, Signe T Andersen, Dorte Vistisen, Søren Brage, Annelli Sandbæk, Daniel R Witte

Abstract read
In one paragraph

Article in Diabetes, obesity & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Atrial cardiomyopathy as a multidomain disease: longitudinal evidence for autonomic remodelling.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  2. Review
  3. Review
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jonas R SchaarupDepartment of Public Health, Aarhus University, Aarhus, Denmark.ORCID https://orcid.org/0000-0002-7209-2675
Lasse BjergDepartment of Public Health, Aarhus University, Aarhus, Denmark.ORCID https://orcid.org/0000-0002-4724-7276
Christian S HansenSteno Diabetes Centre Copenhagen, Herlev, Denmark.ORCID https://orcid.org/0000-0002-5782-3476
Erik L GroveDepartment of Clinical Medicine, Aarhus University, Aarhus, Denmark.ORCID https://orcid.org/0000-0002-1466-0865
Signe T AndersenSteno Diabetes Centre Aarhus, Aarhus University Hospital, Aarhus, Denmark.ORCID https://orcid.org/0000-0001-5183-3502
Dorte VistisenNovo Nordisk A/S, Søborg, Denmark.ORCID https://orcid.org/0000-0001-5045-5351
Søren BrageMRC Epidemiology Unit, University of Cambridge, Cambridge, UK.ORCID https://orcid.org/0000-0002-8185-2963
Annelli SandbækDepartment of Public Health, Aarhus University, Aarhus, Denmark.ORCID https://orcid.org/0000-0003-1647-2646
Daniel R WitteDepartment of Public Health, Aarhus University, Aarhus, Denmark.ORCID https://orcid.org/0000-0002-0769-2922

Funding

European Foundation for the Study of Diabetes
6 · The paper itself

Abstract

aimWe aim to determine the impact of multiday heart rate variability (HRV) on the risk of major adverse cardiovascular events (MACE), heart failure and mortality in people at high risk of diabetes. MATERIALS AND

methodsMultiday HRV and mean heart rate (mHR) were measured in 1627 participants from the ADDITION-PRO study between 2009 and 2011. As measurement for HRV, we calculated a proxy for standard deviation of normal heartbeat (SDNN) both weekly, daily and hourly. Data on MACE and all-cause mortality were obtained from Danish patient registers until 2021. We fitted Poisson regression to determine incidence rate ratios (IRR) for MACE (myocardial infarction, stroke and cardiovascular death), heart failure and all-cause mortality.

resultsMean (SD) age was 66 years (7), and 47% were women. The population had a mean (SD) multiday SDNN of 139.0 (32.3) milliseconds. Multiday HRV index SDNN showed an IRR of 0.82 (CI: 0.69; 0.97), 0.76 (CI: 0.58; 0.99) and 0.79 (CI: 0.66; 0.94) per SD for MACE, heart failure and all-cause mortality, respectively. SDNN measurements taken from 6:00 AM to 7:00 AM showed the strongest association with the risk of MACE. Lower SDNN was associated with all-cause mortality across all hours of the day. Adjustment for physical acceleration and heart rate did not materially change the magnitude of these associations.

conclusionCardiovascular autonomic dysfunction, measured by multiday HRV, is linked with MACE, heart failure and all-cause mortality. Certain time frames of the day for HRV and heart rate under free-living conditions showed a higher risk of cardiovascular disease.

Indexed as

Autonomic Nervous SystemAutonomic Nervous System DiseasesCardiovascular DiseasesAgedCause of DeathDenmarkFemaleFollow-Up StudiesHeart RateHumansMaleMiddle AgedRisk FactorsADDITION‐PRO studyall‐cause mortalityautonomic dysfunctionheart failurehigh risk of diabeteshourly heart rate variabilitymultiday heart rate variability

Identifiers

PMID40635178
PMCPMC12326908

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.