Jarczok · Journal of internal medicine 2014 · prospective cohort study · n=106

Lower heart rate variability predicts increased level of C-reactive protein 4 years later in healthy, nonsmoking adults.

Cited 74 times in the scientific literature.

Level 3 - non-randomized controlled study

Prospective longitudinal cohort study

PubMed 25141771 · doi:10.1111/joim.12295 · record verified 2026-08-28

What was done

A prospective cohort study evaluated 106 healthy, nonsmoking employees (9% women, mean age 44.4 ± 8 years) assessed in 2007 and followed up in 2011. Blood samples for C-reactive protein (CRP) and ambulatory nighttime high-frequency heart rate variability (HF-HRV) were measured. Analyses used bootstrapped bivariate correlations and partial Pearson correlations adjusted for baseline age, sex, and body mass index.

What was found

Higher HF-HRV negatively correlated with CRP in 2007 (r = -0.19, P < 0.05) and in 2011 (r = -0.34, P < 0.001). After adjusting for baseline sex, age, and body mass index, baseline HF-HRV remained a significant predictor of CRP at 4-year follow-up (partial Pearson correlation = -0.20, P < 0.05).

Why it matters

These findings provide prospective human evidence that lower vagally mediated heart rate variability precedes elevated systemic inflammation, supporting the cholinergic anti-inflammatory pathway.

Limits

The sample size is relatively small (n = 106) and heavily skewed toward men (91%). Residual confounding from lifestyle factors (e.g., diet, exercise, sleep) was not accounted for in the abstract.

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