Wekenborg · Annals of epidemiology 2023 · cross-sectional mediation study · n=388

Exhaustion and cardiovascular risk factors: the role of vagally-mediated heart rate variability.

Cited 7 times in the scientific literature.

Level 4 - case-series / case-control

Cross-sectional mediation analysis in an observational cohort

PubMed 37748549 · doi:10.1016/j.annepidem.2023.09.008 · record verified 2026-08-28

What was done

Mediation analysis was conducted using data from 388 participants in the Dresden Burnout Study (72.9% female, mean age 42.61 ± 11.67 years). The authors evaluated whether vagally-mediated heart rate variability (vmHRV) mediated the association between exhaustion symptoms and self-reported cardiovascular disease (CVD) risk factors, adjusting for sex, body mass index, and depressive symptoms, and assessed whether this mediation varied by age.

What was found

Exhaustion symptoms showed an indirect association with self-reported CVD risk factors through vmHRV after controlling for sex, BMI, and depressive symptoms. This indirect pathway was statistically significant only among middle-aged (referenced at 54.27 years) and older individuals. The abstract reported no exact effect sizes, test statistics, or confidence intervals.

Why it matters

The study suggests autonomic imbalance, specifically reduced vagal tone, may be a physiological mechanism linking exhaustion symptoms to cardiovascular risk in older demographic groups.

Limits

The cross-sectional design cannot establish temporal precedence or causality. CVD risk factors were self-reported rather than objectively measured. The sample was predominantly female (72.9%), and numerical effect estimates were omitted from the abstract.

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