Age and Sex Differences in Heart Rate Variability and Vagal Specific Patterns – Baependi Heart Study

Abstract

Background: Heart rate variability (HRV) is a noninvasive method for assessing autonomic function. Age, sex, and chronic conditions influence HRV. Objectives: Our aim was to evaluate HRV measures exploring differences by age, sex, and race in a sample from a rural area. Methods: Analytical sample (n = 1,287) included participants from the 2010 to 2016 evaluation period of the Baependi Heart Study, a family-based cohort in Brazil. Participants underwent 24-hour Holter-ECG (Holter) monitoring. To derive population reference values, we restricted our analysis to a ‘healthy’ subset (i.e. absence of medical comorbidities). A confirmatory analysis was conducted with a subgroup sample that also had HRV derived from a resting ECG 10’-protocol obtained during the same time period. Results: The ‘healthy’ subset included 543 participants. Mean age was 40 ± 14y, 41% were male, 74% self-referred as white and mean body-mass-index was 24 ± 3kg/m 2 . Time domain HRV measures showed significant differences by age-decade and by sex. Higher values were observed for males across almost all age-groups. Parasympathetic associated variables (rMSSD and pNN50) showed a U-shaped distribution and reversal increase above 60y. Sympathetic-parasympathetic balance variables (SDNN, SDANN) decreased linearly by age. Race differences were no significant. We compared time domain variables with complete data (Holter and resting ECG) between ‘healthy’ versus ‘unhealthy’ groups. Higher HRV values were shown for the ‘healthy’ subset compared with the ‘unhealthy’ group. Conclusion: HRV measures vary across age and sex. A U-shaped pattern and a reversal increase in parasympathetic variables may reflect an age-related autonomic dysfunction even in healthy individuals that could be used as a predictor of disease development.

Association Between Postoperative Long-Term Heart Rate Variability and Postoperative Delirium in Elderly Patients Undergoing Orthopedic Surgery: A Prospective Cohort Study

“…However, it should not be ignored that some of the HRV indices show a non-linear decreasing pattern as age increased. Results of two cohort studies in Brazil showed that parasympathetic associated time domain variables showed a U-shaped distribution and reversal increase between 60 and 70 years old, which were consistent with trend of the frequency domain parameters (HF) changing with age in our cohort (Almeida-Santos et al, 2016;Geovanini et al, 2020; Supplementary Table 4). Theoretically, the VLF band, which contributed mainly by parasympathetic nervous system activity, may display a reversal process in old-old patients (Berntson et al, 1997;Taylor et al, 1998).…”

Heart Rate Variability Analyses in Parkinson’s Disease: A Systematic Review and Meta-Analysis

“…It is known that age and sex have an important impact on HRV [67][68][69][70][71]. Aging causes neuronal and structural modifications of the cardiorespiratory system leading to a decreased vagal tone [68,70].…”

Heart rate variability in late pregnancy: exploration of distinctive patterns in relation to maternal mental health

“…Given the consistency between HRV values during pregnancy in this and others studies, it may be possible to identify normal ranges of values. Normal values for HRV measures may need to be adjusted for factors including age and different hormonal states across the perinatal period 77 , 78 . As an example for the latter from the literature, trait anxiety was found to be associated with greater decrease in HF and greater HF reactivity in the third trimester; along with greater increase in VLF compared with the second trimester 41 , 42 .…”