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June 8, 2026Journal of the American College of Cardiology1,160 citations

Twenty-Four Hour Time Domain Heart Rate Variability and Heart Rate: Relations to Age and Gender Over Nine Decades

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KUKen UmetaniDSDonald H. SingerRMRollin McCraty

Key Result

Heart rate variability declines with aging, reaching 24% to 60% of baseline depending on the measure, and is lower in females than males under age 30.

Key Points

  • To explore the relationships between time domain heart rate variability, heart rate, age, and gender across a lifespan of nine decades.
  • Analyzed heart rate and variability measurements over a 24-hour period.
  • Utilized a time domain approach for assessing heart rate variability.
  • Included a diverse age range from young adults to the elderly.
  • Increased age is associated with lower heart rate variability, indicating reduced autonomic regulation.
  • Gender differences were noted, with women showing higher heart rate variability than men in older age groups.
  • Heart rate trends varied significantly across different age decades, reflecting cardiovascular changes.

Study Design

Type

Cross-Sectional (n=260)

Structured PICO

How do age and gender affect 24-hour time domain heart rate variability and heart rate in healthy subjects?

P
Population
260 healthy subjects aged 10 to 99 years evaluated for 24-hour heart rate variability to determine the effects of age and gender.
O
Outcome
24-h heart rate (HR) and heart rate variability (SDNN, SDANN, SDNN index, rMSSD, pNN50)surrogate

Normal aging and gender significantly influence heart rate variability, with healthy elderly subjects frequently exhibiting HRV levels that fall below established cutpoints for increased mortality risk.

Abstract

OBJECTIVES: This study sought to define the effects of age and gender effects on the normal range of time domain heart rate variability (HRV) over nine decades in healthy subjects. BACKGROUND: Low HRV is considered an independent marker of mortality risk. However, the age-related decline in HRV may limit its predictive value, particularly in the elderly. Delineation of the range of HRV in healthy subjects over the life span is needed. Gender-related differences in HRV also need clarification. METHODS: We determined, according to decade, 24-h heart rate (HR) and HRV of 260 healthy subjects (10 to 99 years old; 112 male, 148 female) by means of five standard time domain measures: standard deviation of all normal sinus RR intervals over 24 h (SDNN), standard deviation of the averaged normal sinus RR intervals for all 5-mm segments (SDANN), mean of the standard deviations of all normal sinus RR intervals for all 5-min segments (SDNN index), root-mean-square of successive normal sinus RR interval difference (rMSSD) and the percentage of successive normal sinus RR intervals >50 ms (pNN50). RESULTS: 1) HRV decreased with aging, the pattern of change being measure dependent. HRV (SDNN and SDANN) decreased only very gradually, reaching 60% of baseline (second-decade values) by the tenth decade. With the SDNN index, HRV decreased linearly with aging, reaching 46% of baseline by the tenth decade. Using pNN50 and rMSSD, HRV decreased most rapidly, reaching 24% and 47% of baseline, respectively, by the sixth decade and then stabilized. 2) Using the SDNN index, rMSSD and pNN50, HRV of subjects >65 years old fell below published cutpoints for increased risk of mortality in 25%, 12% and 4%, respectively. 3) At age 30 years and disappeared at age >50 years. 4) HR also declined with aging but much more slowly. HR at age 65 years old, may decrease to below levels associated with increased risk of mortality. 3) Gender influences HRV. Gender differences in HRV are age and measure dependent. 4) Age and gender also affect heart rate.

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Cite This Study

Umetani et al. (1998) conducted a cross-sectional in Healthy subjects (n=260). Age and gender was evaluated on 24-h heart rate and heart rate variability (SDNN, SDANN, SDNN index, rMSSD, pNN50). Heart rate variability declines with aging, reaching 24% to 60% of baseline depending on the measure, and is lower in females than males under age 30.

synapsesocial.com/papers/6a26dd6bf9eacc3aef325d10https://doi.org/10.1016/s0735-1097(97)00554-8
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Also Consider

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

  1. 1Aging of modulation of heart rate1987 · 209 citations
  2. 2Heart Rate Variability in Diabetes: Relationship to Age and Duration of the Disease1985 · 115 citations
  3. 3The effect of ageing on autonomic nervous system function1990 · 92 citations
  4. 4Heart rate variability in healthy subjects: effect of age and the derivation of normal ranges for tests of autonomic function.1986 · 484 citations
  5. 5Sex-Related Differences in Autonomic Modulation of Heart Rate in Middle-aged Subjects1996 · 449 citations