Purpose The importance of cardiorespiratory fitness vs. adiposity in determining heart rate variability (HRV) is unclear. Methods From CARDIA, an observational cohort study, we included 2,316 participants (mean age 45.2±3.6 years at Year 20, 57% female, 43% black) with HRV measured in 2005–06 (Year 20), and graded exercise test duration (GXTd) and adiposity measures (BMI, waist circumference) obtained in 1985–86 (baseline) and 2005–06. HRV measures (standard deviation of all normal RR intervals [SDNN] and square root of the mean of the squares of differences between all successive RR intervals [RMSSD]) were obtained from resting 30-second 12-lead ECGs. Cross-sectional associations between GXTd, adiposity and HRV were assessed at Year 20. Longitudinal changes in GXTd and adiposity measures were categorized as ≥10% increase,
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