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Our comment is related the paper by Javady Nejad et al.(1) where they reported cardiovascular autonomic control in 44 rheumatoid arthritis (RA) patients and 44 healthy subjects. Until now, the involvement of the autonomic nervous system in chronic systemic inflammatory disorders is disputable. Several authors reported significant differences in cardiovascular autonomic control in RA patients and healthy subjects: Refs. 3, 7, and 10-14 in the paper by Javady Nejad et al.(1).

The strong point of the cross-sectional study performed by Javady Nejad et al.(1) is the employment of a variety of cardiovascular autonomic function tests, namely, deep breathing with a frequency of 6 breaths per minute, active tilt test, Valsalva maneuver, and sustained handgrip. On the contrary to previous results, the authors found no difference between the RA patients and control subjects in their responses to the autonomic function tests. This important result requires an additional analysis. The ECG recording was performed by Nejad et al.(1) during all tests. Therefore, it is advisable to further explore the indicators of heart rate variability (HRV)(2) that may complement the classical interpretation of the cardiovascular autonomic function test results.