{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T03:04:37Z","timestamp":1792897477277,"version":"4.5.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec id=\"jah34446-sec-0001\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Increased vagal modulation is a mechanism that may partially explain the protective effect of healthy lifestyles. However, it is unclear how healthy lifestyles relate to vagal regulation longitudinally. We prospectively examined associations between a comprehensive measure of 4 important lifestyle factors and vagal modulation, indexed by heart rate variability (HRV) over 10 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"jah34446-sec-0002\" xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The fifth (1997\u20131999), seventh (2002\u20132004), and ninth (2007\u20132009) phases of the\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">UK<\/jats:styled-content>\n                      Whitehall\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">II<\/jats:styled-content>\n                      cohort were analyzed. Analytical samples ranged from 2059 to 3333 (mean age: 55.7\u00a0years). A healthy lifestyle score was derived by giving participants 1 point for each healthy factor: physically active, not smoking, moderate alcohol consumption, and healthy body mass index. Two vagally mediated HRV measures were used: high\u2010frequency\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">HRV<\/jats:styled-content>\n                      and root mean square of successive differences of normal\u2010to\u2010normal R\u2010R intervals. Cross\u2010sectionally, a positively graded association was observed between the healthy lifestyle score and HRV at baseline (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:sub>overall<\/jats:sub>\n                      \u22640.001). Differences in HRV according to the healthy lifestyle score remained relatively stable over time. Compared with participants who hardly ever adhered to healthy lifestyles, those with consistent healthy lifestyles displayed higher high\u2010frequency\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">HRV<\/jats:styled-content>\n                      (\u03b2=0.23; 95%\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">CI<\/jats:styled-content>\n                      , 0.10\u20130.35;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.001) and higher root mean square of successive differences of normal\u2010to\u2010normal R\u2010R intervals (\u03b2=0.15; 95%\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">CI<\/jats:styled-content>\n                      , 0.07\u20130.22;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u22640.001) at follow\u2010up after covariate adjustment. These differences in high\u2010frequency\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">HRV<\/jats:styled-content>\n                      and root mean square of successive differences of normal\u2010to\u2010normal R\u2010R intervals are equivalent to \u22486 to 20\u00a0years differences in chronological age. Compared with participants who reduced their healthy lifestyle scores, those with stable scores displayed higher subsequent high\u2010frequency\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">HRV<\/jats:styled-content>\n                      (\u03b2=0.24; 95% CI, 0.01\u20130.48;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.046) and higher root mean square of successive differences of normal\u2010to\u2010normal R\u2010R intervals (\u03b2=0.15; 95%\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">CI<\/jats:styled-content>\n                      , 0.01\u20130.29;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.042).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"jah34446-sec-0003\" xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Maintaining healthy lifestyles is positively associated with cardiac vagal functioning, and these beneficial adaptations may be lost if not sustained.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.119.012420","type":"journal-article","created":{"date-parts":[[2019,9,24]],"date-time":"2019-09-24T05:04:09Z","timestamp":1569301449000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":31,"title":["Healthy Lifestyle and Cardiac Vagal Modulation Over 10 Years: Whitehall II Cohort Study"],"prefix":"10.1161","volume":"8","author":[{"given":"Vera K.","family":"Jandackova","sequence":"first","affiliation":[{"name":"University of Ostrava"},{"name":"University of Ostrava"},{"name":"University College London","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaun","family":"Scholes","sequence":"additional","affiliation":[{"name":"University College London","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Britton","sequence":"additional","affiliation":[{"name":"University College London","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Steptoe","sequence":"additional","affiliation":[{"name":"University College London","place":["United Kingdom"]},{"name":"University College London","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)17018-9"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.07.981"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000058"},{"key":"e_1_3_1_5_2","first-page":"0039","article-title":"Combined impact of health behaviours and mortality in men and women: the EPIC\u2010Norfolk prospective population study","volume":"5","author":"Khaw KT","year":"2008","unstructured":"Khaw KT, Wareham N, Bingham S, Welch A, Luben R, Day N. 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