Key result
Anticholinergic medication burden (β = -0.19), as well as diagnoses of schizophrenia (β = -0.23) and depression (β = -0.18), independently and negatively influenced ambulatory heart rate variability.
Why the study?
Heart rate variability is reduced in schizophrenia and depression, but how demographic, lifestyle, and pharmacological factors contribute to this reduction is not well known.
Do schizophrenia, depression, and anticholinergic medication burden independently reduce heart rate variability?
Cross-Sectional (n=144)
No
Do schizophrenia, depression, and anticholinergic medication burden independently reduce heart rate variability?
Both psychiatric diagnoses (schizophrenia and depression) and the anticholinergic burden of medications independently contribute to reduced heart rate variability.
Anticholinergic burden may lower HRV in schizophrenia and depression; leaves open whether dose reduction improves outcomes.
BACKGROUND: Heart rate variability (HRV) has been found reduced in patients with schizophrenia and depression. However, there is a lack of knowledge on how demographic, lifestyle, and pharmacological factors contribute to the reduction in HRV in these patients. METHODS: We recruited 37 patients with schizophrenia, 43 patients with unipolar depression, and 64 healthy controls. A combined chest-worn HRV and accelerometer device was used in an ambulatory measurement. Age, sex, anticholinergic burden of medication, nicotine use, body mass index, and ongoing physical activity were assessed in multiple regression models regarding their influence on HRV, measured as the standard deviation of all the RR intervals (SDNN). RESULTS: In the fully adjusted model, schizophrenia (β = -0.23, P = 0.019), depression (β = -0.18, P = 0.028), age (β = -0.34, P < 0.000), ongoing physical activity (β = -0.23, P = 0.001), and anticholinergic burden (β = -0.19, P = 0.025) influenced SDNN negatively. Sex, nicotine use, and BMI had negligible effects on SDNN. CONCLUSIONS: We show for the first time that a quantified score of anticholinergic burden of medication has a negative relationship to HRV in patients with schizophrenia or depression, but that the diagnoses themselves still exhibit an effect on HRV.
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Bengtsson et al. (2021) conducted a cross-sectional in Schizophrenia or Depression (n=144). Anticholinergic burden, schizophrenia, and depression vs. Healthy controls and low anticholinergic burden was evaluated on Heart rate variability measured as the standard deviation of all RR intervals (SDNN) (β = -0.19, p=0.025). Anticholinergic medication burden (β = -0.19), as well as diagnoses of schizophrenia (β = -0.23) and depression (β = -0.18), independently and negatively influenced ambulatory heart rate variability.
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