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April 12, 2026MedicineOpen Access

Elevated heart rate variability doubled the risk of early kidney damage (HR 2.00) in hypertensive patients, with LDL cholesterol mediating 22.5% of this association.

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Why the study?

Is higher heart rate variability associated with an increased risk of early kidney damage in hypertensive patients?

Population

1250 hypertensive patients treated between 2015 and 2020 in Hebei Province, China

Comparison

Highest quartile of heart rate variability… vs Lowest quartile of heart rate variability

Design

Cohort

Follow-up

through December 31, 2022

Key result

Elevated heart rate variability doubled the risk of early kidney damage (HR 2.00) in hypertensive patients, with LDL cholesterol mediating 22.5% of this association.

Authors

NXNingning XieFGFang GaoWZWeidong Zhao

Discussion

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Overview

Elevated heart rate variability is associated with an increased risk of early kidney damage in hypertensive patients, a relationship partially mediated by LDL-C levels.

Key Points

  • This research investigates how heart rate variability relates to early kidney damage in hypertensive patients, focusing on blood lipid levels.
  • Conducted a retrospective cohort study involving 1250 hypertensive patients.
  • Monitored heart rate variability using 24-hour Holter recordings.
  • Employed Cox proportional hazards models to calculate hazard ratios for early kidney damage.
  • Performed exploratory mediation analysis for assessing lipid influence.
  • Higher heart rate variability is associated with a nearly doubled risk of early kidney damage.
  • Low-density lipoprotein cholesterol explained about 22.5% of the relationship between heart rate variability and early kidney damage.
  • Sensitivity analyses confirmed the reliability of the findings across various models.

Structured PICO

Is higher heart rate variability associated with an increased risk of early kidney damage in hypertensive patients?

P
Population
1250 hypertensive patients treated between 2015 and 2020 in Hebei Province, China
I
Intervention
Highest quartile of heart rate variability (HRV) measured by 24-hour Holter monitoring (SDNN)
C
Comparator
Lowest quartile of heart rate variability
O
Outcome
Early kidney damage (EKD)surrogate

Elevated heart rate variability is associated with an increased risk of early kidney damage in hypertensive patients, a relationship partially mediated by LDL-C levels.

Cite This Study

Xie et al. (2026) studied this question. Elevated heart rate variability doubled the risk of early kidney damage (HR 2.00) in hypertensive patients, with LDL cholesterol mediating 22.5% of this association.

synapsesocial.com/papers/69db375f4fe01fead37c5674https://doi.org/10.1097/md.0000000000048197
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Assessment of cardiac autonomic dysfunction in patients with chronic kidney disease using heart rate variability2025
  2. 2Appraisal of Relationship between Hypertension and Short-Term Heart Rate Variability Indices2025
  3. 3Heart Rate Variability's Value in Predicting Out-of-Hospital Major Adverse Cardiovascular Events in Patients With Chronic Heart Failure.2025 · 4 citations
  4. 4Associations of vitamin D with coronary revascularization and heart rate variability in hypertensive patients2025
  5. 5Non-conventional lipid parameters predict the risk of rapid kidney function decline in patients with cardiovascular-kidney-metabolic syndrome: The first cohort study evidence from CHARLS2025 · 5 citations