June 26, 2019Psychological Medicine481 citationsOpen Access
A meta-analysis of heart rate variability in major depression
Key Result
Unmedicated adults with major depression had significantly lower resting-state heart rate variability, including HF-HRV (Hedges' g -0.318; 95% CI -0.388 to -0.247), compared to healthy controls.
Study Design
Type
Meta-Analysis (n=4,232)
Structured PICO
Does major depression reduce resting-state heart rate variability compared to healthy controls?
P
Population
21 studies including 2,250 unmedicated adults with major depression (MD) and 1,982 controls
I
Intervention
Major depression (unmedicated)
C
Comparator
Healthy controls
O
Outcome
Resting-state measures of heart rate variability (HRV) including frequency domains (HF-HRV, LF-HRV, LF/HF-HRV, VLF-HRV) and time-domains (IBI, RMSSD, SDNN)surrogate
Unmedicated adults with major depression have significantly lower resting-state heart rate variability compared to healthy controls, highlighting a potential physiological mediator for increased cardiovascular risk.
Main Result
Effect estimate: Hedges' g -0.318 (95% CI -0.388 to -0.247)
Abstract
BACKGROUND: Major depression (MD) is a risk factor for cardiovascular disease. Reduced heart rate variability (HRV) has been observed in MD. Given the predictive value of HRV for cardiovascular health, reduced HRV might be one physiological factor that mediates this association. METHODS: The purpose of this study was to provide up-to-date random-effects meta-analyses of studies which compare resting-state measures of HRV between unmedicated adults with MD and controls. Database search considered English and German literature to July 2018. RESULTS: A total of 21 studies including 2250 patients and 1982 controls were extracted. Significant differences between patients and controls were found for (i) frequency domains such as HF-HRV Hedges' g = -0.318; 95% CI (-0.388 to -0.247), LF-HRV (Hedges' g = -0.195; 95% CI (-0.332 to -0.059)], LF/HF-HRV (Hedges' g = 0.195; 95% CI (0.086-0.303)] and VLF-HRV (Hedges' g = -0.096; 95% CI (-0.179 to -0.013)), and for (ii) time-domains such as IBI (Hedges' g = -0.163; 95% CI (-0.304 to -0.022)], RMSSD (Hedges' g = -0.462; 95% CI (-0.612 to -0.312)] and SDNN (Hedges' g = -0.266; 95% CI (-0.431 to -0.100)]. CONCLUSIONS: Our findings demonstrate that all HRV-measures were lower in MD than in healthy controls and thus strengthens evidence for lower HRV as a potential cardiovascular risk factor in these patients.