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Association of Resting Heart Rate and Blood Pressure in Late Adolescence With Subsequent Mental Disorders: A Longitudinal Population Study of More Than 1 Million Men in Sweden
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Public Health, University of Helsinki, Helsinki, Finland.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Department of Psychological and Brain Sciences, Indiana University, Bloomington, USA.
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2016 (English)In: JAMA psychiatry, ISSN 2168-6238, E-ISSN 2168-622X, Vol. 73, no 12, 1268-1275 p.Article in journal (Refereed) Published
Abstract [en]

Importance: Differences in cardiovascular autonomic activity between individuals with psychiatric disorders and healthy controls have been observed, but whether cardiovascular autonomic abnormalities are associated with subsequent psychiatric disorders is unknown.

Objective: To investigate whether differences in cardiac autonomic function as indexed by resting heart rate and blood pressure are associated with psychiatric disorders during the lifetime of men in Sweden.

Design, Setting, and Participants: We conducted a longitudinal register-based study of Swedish men whose resting heart rate (n = 1 039 443) and blood pressure (n = 1 555 979) were measured at military conscription at a mean (SD) age of 18.3 (0.6) years during the period from 1969 to 2010, with register-based follow-up data available until the end of 2013. Analyses were performed from November 18, 2015, to June 9, 2016.

Main Outcomes and Measures: Dates of inpatient/outpatient diagnoses of anxiety disorders, obsessive-compulsive disorder, posttraumatic stress disorder, depressive disorders, bipolar disorder, schizophrenia, and substance use disorders and convictions for violent crimes, between 1973 and 2013, were obtained from nationwide registers. Adjustments were made for height, weight, body mass index, cardiorespiratory fitness, cognitive ability, and socioeconomic covariates.

Results: After adjustment for covariates, Cox regression models with up to 45 years of follow-up data showed that men (mean [SD] age of 18.3 [0.6] years at conscription) with resting heart rates above 82 beats per minute had a 69% (95% CI, 46%-94%) increased risk for obsessive-compulsive disorder, a 21% (95% CI, 11%-33%) increased risk for schizophrenia, and an 18% (95% CI, 13%-22%) increased risk for anxiety disorders compared with men with resting heart rates below 62 beats per minute. Similar associations were observed with systolic/diastolic blood pressure. In contrast, lower resting heart rate and lower systolic blood pressure were associated with substance use disorders and violent criminality.

Conclusions and Relevance: Our results suggest that for men, differences in heart rate and blood pressure in late adolescence are associated with lifetime major psychiatric disorders, with higher levels associated with obsessive-compulsive disorder, schizophrenia, and anxiety disorders and lower levels associated with substance use disorders and violent behavior. Differences in autonomic nervous system functioning may predate or represent an early marker of psychiatric disorders.

Place, publisher, year, edition, pages
Chicago, USA: American Medical Association , 2016. Vol. 73, no 12, 1268-1275 p.
National Category
Cardiac and Cardiovascular Systems Psychiatry
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URN: urn:nbn:se:oru:diva-53358DOI: 10.1001/jamapsychiatry.2016.2717ISI: 000390666900012PubMedID: 27784035OAI: oai:DiVA.org:oru-53358DiVA: diva2:1044207
Swedish Research Council, K2013-61P-22168

Funding Agencies:

Academy of Finland 277209

Swedish Research Council for Health, Working Life and Welfare

Swedish Research Council through the Swedish Initiative for Research on Microdata in the Social and Medical Sciences 340-2013-5867

Available from: 2016-11-02 Created: 2016-11-02 Last updated: 2017-01-19Bibliographically approved

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