Determinants of heart rate variability

Kansai Medical University, Osaka, Japan.

OBJECTIVES: This study sought to examine clinical determinants of heart rate variability and to report normative reference values for eight heart rate variability measures. BACKGROUND: Although the clinical implications of heart rate variability have been described, clinical determinants and normative values of heart rate variability measures have not been studied systematically in a large community-based population. METHODS: The first 2 h of ambulatory electrocardiographic recordings obtained in Framingham Heart Study subjects attending a routine examination were reprocessed for heart rate variability. Recordings with transient or persistent nonsinus rhythm, premature beats > 10% of total beats, < 1-h recording time or processed time < 50% of recorded time were excluded; subjects receiving antiarrhythmic medications also were excluded. Among five frequency domain and three time domain measures that were obtained, low frequency power (0.04 to 0.15 Hz), high frequency power (0.15 to 0.40 Hz) and the standard deviation of total normal RR intervals based on 2-h recordings were selected for the principal analyses. Variables with potential physiologic effects or possible technical influences on heart rate variability measures were chosen for multiple linear regression analysis. Normative values, derived from a subset of healthy subjects, were adjusted for age and heart rate. RESULTS: There were 2,722 eligible subjects with a mean age (+/-SD) of 55 +/- 14 years. Three separate multiple linear regression analyses revealed that higher heart rate, older age, beta-adrenergic blocking agent use, history of myocardial infarction or congestive heart failure, diuretic use, diastolic blood pressure > or = 90 mm Hg, diabetes mellitus, consumption of three or more cups of coffee per day and smoking were associated with lower values of one or more heart rate variability measures, whereas longer processed time, start time in the morning, frequent supraventricular and ventricular premature beats, female gender and systolic blood pressure > or = 160 mm Hg were associated with higher values. Age and heart rate were the major determinants of all three selected heart rate variability measures (partial R2 values 0.125 to 0.389). Normative reference values for all eight heart rate variability measures are presented. CONCLUSIONS: Age and heart rate must be taken into account when assessing heart rate variability.

This article has been cited by other articles:

				C. F. A. Eustatia-Rutten, E. P. M. Corssmit, K. A. Heemstra, J. W. A. Smit, R. C. Schoemaker, J. A. Romijn, and J. Burggraaf Autonomic Nervous System Function in Chronic Exogenous Subclinical Thyrotoxicosis and the Effect of Restoring Euthyroidism J. Clin. Endocrinol. Metab., July 1, 2008; 93(7): 2835 - 2841. [Abstract] [Full Text] [PDF]

				P. Ptaszynski, T. Klingenheben, B. Gerritse, and L. Kornet Risk stratification after myocardial infarction: a new method of determining the neural component of the baroreflex is potentially more discriminative in distinguishing patients at high and low risk for arrhythmias Europace, February 1, 2008; 10(2): 227 - 234. [Abstract] [Full Text] [PDF]

				G A Lanza, D Cianflone, A G Rebuzzi, G Angeloni, A Sestito, G Ciriello, G La Torre, F Crea, A Maseri, and for the Stratificazione Prognostica dell'Angina In Prognostic value of ventricular arrhythmias and heart rate variability in patients with unstable angina Heart, August 1, 2006; 92(8): 1055 - 1063. [Abstract] [Full Text] [PDF]

				D. Felber Dietrich, C. Schindler, J. Schwartz, J.-C. Barthelemy, J.-M. Tschopp, F. Roche, A. von Eckardstein, O. Brandli, P. Leuenberger, D. R. Gold, et al. Heart rate variability in an ageing population and its association with lifestyle and cardiovascular risk factors: results of the SAPALDIA study Europace, July 1, 2006; 8(7): 521 - 529. [Abstract] [Full Text] [PDF]

				P. J. Gianaros, K. Salomon, F. Zhou, J. F. Owens, D. Edmundowicz, L. H. Kuller, and K. A. Matthews A Greater Reduction in High-Frequency Heart Rate Variability to a Psychological Stressor is Associated With Subclinical Coronary and Aortic Calcification in Postmenopausal Women Psychosom Med, July 1, 2005; 67(4): 553 - 560. [Abstract] [Full Text] [PDF]

				E. B. Schroeder, L. E. Chambless, D. Liao, R. J. Prineas, G. W. Evans, W. D. Rosamond, and G. Heiss Diabetes, Glucose, Insulin, and Heart Rate Variability: The Atherosclerosis Risk in Communities (ARIC) study Diabetes Care, March 1, 2005; 28(3): 668 - 674. [Abstract] [Full Text] [PDF]

				I Janszky, M Ericson, M Blom, A Georgiades, J-O Magnusson, H Alinagizadeh, and S Ahnve Wine drinking is associated with increased heart rate variability in women with coronary heart disease Heart, March 1, 2005; 91(3): 314 - 318. [Abstract] [Full Text] [PDF]

				M.J. Reed, C.E. Robertson, and P.S. Addison Heart rate variability measurements and the prediction of ventricular arrhythmias QJM, February 1, 2005; 98(2): 87 - 95. [Full Text] [PDF]

				L. MONTEBUGNOLI, D. SERVIDIO, R. A. MIATON, and C. PRATI Heart rate variability: A sensitive parameter for detecting abnormal cardiocirculatory changes during a stressful dental procedure J Am Dent Assoc, December 1, 2004; 135(12): 1718 - 1723. [Abstract] [Full Text] [PDF]

				T. Laitinen, L. Niskanen, G. Geelen, E. Lansimies, and J. Hartikainen Age dependency of cardiovascular autonomic responses to head-up tilt in healthy subjects J Appl Physiol, June 1, 2004; 96(6): 2333 - 2340. [Abstract] [Full Text] [PDF]

				J. A. Masters, J. S. Stevenson, and S. F. Schaal The Association Between Moderate Drinking and Heart Rate Variability in Healthy Community-Dwelling Older Women Biol Res Nurs, January 1, 2004; 5(3): 222 - 233. [Abstract] [PDF]

				E. B. Schroeder, D. Liao, L. E. Chambless, R. J. Prineas, G. W. Evans, and G. Heiss Hypertension, Blood Pressure, and Heart Rate Variability: The Atherosclerosis Risk in Communities (ARIC) Study Hypertension, December 1, 2003; 42(6): 1106 - 1111. [Abstract] [Full Text] [PDF]

				S Z Abildstrom, C Rask-Madsen, M M Ottesen, P K Andersen, S Rosthoj, C Torp-Pedersen, and L Kober Impact of age and sex on sudden cardiovascular death following myocardial infarction Heart, December 1, 2002; 88(6): 573 - 578. [Abstract] [Full Text] [PDF]

				C. Panzer, M. S. Lauer, A. Brieke, E. Blackstone, and B. Hoogwerf Association of Fasting Plasma Glucose With Heart Rate Recovery in Healthy Adults: A Population-Based Study Diabetes, March 1, 2002; 51(3): 803 - 807. [Abstract] [Full Text] [PDF]

				S H Poulsen, S E Jensen, J E Moller, and K Egstrup Prognostic value of left ventricular diastolic function and association with heart rate variability after a first acute myocardial infarction Heart, October 1, 2001; 86(4): 376 - 380. [Abstract] [Full Text] [PDF]

				A. Zaza and F. Lombardi Autonomic indexes based on the analysis of heart rate variability: a view from the sinus node Cardiovasc Res, June 1, 2001; 50(3): 434 - 442. [Abstract] [Full Text] [PDF]

				H. V. Huikuri, A.-M. Poutiainen, T. H. Makikallio, M. J. Koistinen, K. E. J. Airaksinen, R. D. Mitrani, R. J. Myerburg, and A. Castellanos Dynamic Behavior and Autonomic Regulation of Ectopic Atrial Pacemakers Circulation, September 28, 1999; 100(13): 1416 - 1422. [Abstract] [Full Text] [PDF]

				J. P. Singh, M. G. Larson, C. J. O'Donnell, H. Tsuji, J. C. Evans, and D. Levy Heritability of Heart Rate Variability : The Framingham Heart Study Circulation, May 4, 1999; 99(17): 2251 - 2254. [Abstract] [Full Text] [PDF]

				H. Otzenberger, C. Gronfier, C. Simon, A. Charloux, J. Ehrhart, F. Piquard, and G. Brandenberger Dynamic heart rate variability: a tool for exploring sympathovagal balance continuously during sleep in men Am J Physiol Heart Circ Physiol, September 1, 1998; 275(3): H946 - H950. [Abstract] [Full Text] [PDF]

				J. P. Singh, M. G. Larson, H. Tsuji, J. C. Evans, C. J. O'Donnell, and D. Levy Reduced Heart Rate Variability and New-Onset Hypertension : Insights Into Pathogenesis of Hypertension: The Framingham Heart Study Hypertension, August 1, 1998; 32(2): 293 - 297. [Abstract] [Full Text] [PDF]