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November 1, 1996Journal of the American College of CardiologyOpen Access

Age and heart rate were the major determinants of all three selected heart rate variability measures (partial R2 values 0.125 to 0.389).

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Why the study?

What are the clinical determinants and normative reference values of heart rate variability in a community-based population?

Population

2,722 subjects from the Framingham Heart Study attending a routine examination, mean age 55 +/- 14 years…

Design

Cross-sectional

Authors

HTHisako TsujiFVFerdinand J. VendittiEMEmily S Manders

Discussion

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Overview

Supports adjustment for age and heart rate when interpreting HRV; leaves open impact on clinical outcomes.

Key Points

  • To identify clinical and physiological determinants of heart rate variability and establish normative reference values for eight measures in a large community-based cohort.
  • Analyzed the initial 2-hour segments of ambulatory electrocardiographic recordings from N=2,722 Framingham Heart Study participants (mean age 55 ± 14 years), excluding individuals with nonsinus rhythm, excessive ectopy, or antiarrhythmic drug use.
  • Evaluated eight metrics (five frequency domain and three time domain), selecting low frequency power, high frequency power, and the standard deviation of normal RR intervals for multiple linear regression.
  • Generated normative reference values adjusted for age and heart rate from a healthy participant subset.
  • Older age and higher heart rate were the dominant determinants of lower heart rate variability across all three primary measures, explaining substantial variance (partial R² values 0.125 to 0.389).
  • Lower variability was independently associated with beta-blockers, history of myocardial infarction or congestive heart failure, diuretics, diastolic blood pressure ≥90 mm Hg, diabetes, coffee intake (≥3 cups/day), and smoking.
  • Higher variability measures were associated with female sex, morning recording start times, longer processed time, frequent premature beats, and systolic blood pressure ≥160 mm Hg.

Structured PICO

What are the clinical determinants and normative reference values of heart rate variability in a community-based population?

P
Population
2,722 subjects from the Framingham Heart Study attending a routine examination, mean age 55 +/- 14 years. Excluded: transient or persistent nonsinus rhythm, premature beats > 10% of total beats, < 1-h recording time or processed time < 50% of recorded time, and subjects receiving antiarrhythmic medications.
O
Outcome
Clinical determinants of heart rate variability measures (low frequency power, high frequency power, and standard deviation of total normal RR intervals) and normative reference valuessurrogate

Age and heart rate are the major determinants of heart rate variability and must be accounted for when assessing HRV measures in clinical practice.

Cite This Study

Tsuji et al. (1996) studied this question.

synapsesocial.com/papers/6a19ba20196cd56b09eaa181https://doi.org/10.1016/s0735-1097(96)00342-7
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Reduced heart rate variability and mortality risk in an elderly cohort. The Framingham Heart Study.1994 · 18 citations
  2. 2Determinants of Heart Rate Variability in General Korean Population2001 · 7 citations
  3. 3Heart rate variability in healthy subjects is related to age and gender1997 · 243 citations
  4. 4Short‐term heart rate variability in healthy adults2013 · 11 citations
  5. 5Stability over time of variables measuring heart rate variability in normal subjects1991 · 393 citations