Association between nitrogen dioxide and heart rate variability in a susceptible population

Chang Chuan Chan, Kai Jen Chuang, Ta Chen Su, Lian Yu Lin

Research output: Contribution to journalArticlepeer-review

37 Citations (Scopus)


BACKGROUND: Panel studies have shown a consistent association between changes in the cardiac autonomic nervous system with particulate matters (PM) but less with gaseous pollutants. This study examined the linkage between nitrogen dioxide (NO2) and heart rate variability (HRV) in a susceptible population. METHODS: We recruited a panel of 83 patients from the National Taiwan University Hospital Cardiology Clinic to measure their 24-h HRV by ambulatory electrocardiography. Thirty-nine patients had coronary heart disease (CHD) and another 44 patients had more than one major CHD risk factor. Ambient concentrations of NO2, sulphur dioxide (SO2), carbon monoxide (CO), ozone, and PM less than 10 μm in diameter (PM10) at each participant's close-by monitoring station were used to represent study participants' exposures. We used linear mixed-effects models to analyse the association between individual air pollutants and log10-transformed HRV, with key personal and environmental attributes and co-pollutants being adjusted. RESULTS: We found that an increase in 10 ppb NO2 at 4-h to 8-h moving averages was associated with 1.5-2.4% decreases in the standard deviation of all normal-to-normal intervals (SDNN) in our participants. For every 10 ppb NO2 at 5 and 7-h moving averages, our participants' low frequency was decreased by 2.2 and 2.5%, respectively. In contrast, HRV was not associated with PM10, CO, SO2, or O3. CONCLUSION: Increasing NO2 exposure was found to be associated with decreasing SDNN and low frequency in susceptible populations.

Original languageEnglish
Pages (from-to)580-586
Number of pages7
JournalEuropean Journal of Cardiovascular Prevention and Rehabilitation
Issue number6
Publication statusPublished - Dec 2005
Externally publishedYes


  • Air pollution
  • Autonomic nervous system
  • Epidemiology
  • Heart rate variability
  • Nitrogen dioxide

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Rehabilitation
  • Public Health, Environmental and Occupational Health


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