{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T23:40:31Z","timestamp":1790206831205,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,9,8]],"date-time":"2014-09-08T00:00:00Z","timestamp":1410134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Mannheim Institute of Public Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Intern Med"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Inflammation and vagally mediated heart rate variability (vmHRV) have been implicated in a number of conditions including diabetes and cardiovascular disease. Consistent with the inflammatory reflex termed the \u2018cholinergic anti\u2010inflammatory pathway\u2019, numerous cross\u2010sectional studies have demonstrated negative associations between vmHRV and inflammatory markers such as C\u2010reactive protein (CRP). The only prospective study, however, showed the opposite: higher CRP at baseline predicted higher high\u2010frequency heart rate variability (HF\u2010HRV) at follow\u2010up. Thus, additional studies are needed to examine the prospective association between vmHRV and CRP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Healthy employees participated in a voluntary on\u2010site health assessment. Blood samples and ambulatory heart rate recordings were obtained, and night\u2010time HF\u2010HRV was calculated. Useable heart rate data were available in 2007 for 106 nonsmoking employees (9% women; age 44.4\u00a0\u00b1 8\u00a0years), all of whom returned for an identical follow\u2010up health assessment in 2011. Bootstrapped (500 replications) bivariate (<jats:italic>r<\/jats:italic>) and partial Pearson's correlations (ppc) adjusting for sex, age and body mass index at baseline (2007) were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Zero\u2010order correlations indicated that higher HF\u2010HRV was associated with lower levels of CRP at both time\u2010points (2007: <jats:italic>r<\/jats:italic>\u00a0=\u00a0\u22120.19, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05; 2011: <jats:italic>r<\/jats:italic>\u00a0=\u00a0\u22120.34, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001). After adjustment, HF\u2010HRV remained a significant predictor of CRP (ppc\u00a0= \u22120.20, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this study, we have provided <jats:italic>in vivo<\/jats:italic> support for the cholinergic anti\u2010inflammatory pathway in humans. Cardiac vagal modulation at baseline predicts level of CRP 4\u00a0years later. Our findings have important implications for the role of vmHRV as a risk factor for cardiovascular disease morbidity and mortality. Interventions targeted at vmHRV might be useful in the prevention of diseases associated with elevated systemic inflammation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/joim.12295","type":"journal-article","created":{"date-parts":[[2014,8,20]],"date-time":"2014-08-20T12:07:29Z","timestamp":1408536449000},"page":"667-671","source":"Crossref","is-referenced-by-count":70,"title":["Lower heart rate variability predicts increased level of C\u2010reactive protein 4\u00a0years later in healthy, nonsmoking adults"],"prefix":"10.1111","volume":"276","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6055-385X","authenticated-orcid":false,"given":"M. N.","family":"Jarczok","sequence":"first","affiliation":[{"name":"Mannheim Institute of Public Health, Social and Preventive Medicine Mannheim Medical Faculty Heidelberg University Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Koenig","sequence":"additional","affiliation":[{"name":"Department of Psychology The Ohio State University Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Mauss","sequence":"additional","affiliation":[{"name":"Department of Occupational Medicine Allianz SE Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. E.","family":"Fischer","sequence":"additional","affiliation":[{"name":"Mannheim Institute of Public Health, Social and Preventive Medicine Mannheim Medical Faculty Heidelberg University Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. F.","family":"Thayer","sequence":"additional","affiliation":[{"name":"Department of Psychology The Ohio State University Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,9,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2009.09.543"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.01058.2004"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jash.2011.09.006"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/ni0710-561"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-302550"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2012.189"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2008.02015.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/nri1810"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2008.02023.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-009-0019-0"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.93.5.1043"},{"key":"e_1_2_7_13_1","unstructured":"WittlingA.ANS Explorerhttp:\/\/www.neurocor.de\/produkte_ansexplorer_de.html 2014."},{"key":"e_1_2_7_14_1","first-page":"688","volume-title":"Exploratory Data Analysis","author":"Tukey JW","year":"1977"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2012.01987.x"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2004.11.001"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2010.02321.x"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2011.05.016"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2008.08.007"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1027\/0269-8803\/a000005"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autneu.2005.06.002"}],"container-title":["Journal of Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjoim.12295","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjoim.12295","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/joim.12295","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T20:20:37Z","timestamp":1696191637000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/joim.12295"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9,8]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2014,12]]}},"alternative-id":["10.1111\/joim.12295"],"URL":"https:\/\/doi.org\/10.1111\/joim.12295","archive":["Portico"],"relation":{},"ISSN":["0954-6820","1365-2796"],"issn-type":[{"value":"0954-6820","type":"print"},{"value":"1365-2796","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,9,8]]}}}