René van der Bel

| Chapter 2 | 24 Abstract Baroreflex sensitivity (BRS) denotes the change in heart beat intervals in response to a blood pressure change and has been established as an important determinant of the sympatho- vagal balance. Potentially it could serve as a integrated cardiovascular risk factor. In this study, we present an automated xBRS analysis method for large datasets. We verify the method and explore the associations between BRS, cardiovascular risk factors and cardio- metabolic risk using baseline data from 13,375 participants of the HELIUS study which is currently performed in the city of Amsterdam. Cross-correlation BRS was determined in all available 13,375 continuous finger artery blood pressure recordings. All analyses and data selection procedures were performed using purpose build Matlab and Java scripts, available as supplementary materials. 5,926 BRS calculations could be considered reliable. Automated BRS analysis was successful. Compared to healthy participants at an average age of 44.3 years, BRS is progressively decreased with increasing cardio-metabolic burden up to -7.8 mmHg/ms (p<0.001). Thereby corresponding to the average BRS of a 70 year old person. This relation is also present when stratified for 10 year cardiovascular risk. This study, shows that automated analysis of BRS is feasible and reliable and might be used as a single integrative factor to assess the cardio-metabolic “age” in large populations. Lon- gitudinal studies will have to provide evidence whether BRS is of individual prognostic value, the follow-up of the HELIUS study will provide us with that opportunity.