What question did this study set out to answer?

To systematically evaluate the impact of stress-reducing interventions on heart rate variability parameters and autonomic nervous system regulation in individuals with cardiovascular disease.

June 12, 2024LifeOpen Access

The Effect of Stress-Reducing Interventions on Heart Rate Variability in Cardiovascular Disease: A Systematic Review and Meta-Analysis

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Why the study?

Stress is a significant trigger in cardiovascular disease, and heart rate variability reflects autonomic function and predicts cardiovascular mortality, making the impact of stress-reducing interventions on heart rate variability pertinent to explore.

Do stress-reducing interventions improve heart rate variability in patients with cardiovascular disease?

Key Points

To systematically evaluate the impact of stress-reducing interventions on heart rate variability parameters and autonomic nervous system regulation in individuals with cardiovascular disease.
Systematically reviewed clinical trials examining the effects of stress-reduction techniques on biomarkers and time- and frequency-domain heart rate variability metrics in cardiovascular disease.
Conducted meta-analyses using a random-effects model across short-term and 24-hour evaluation periods.
Stress-reducing interventions significantly increased the standard deviation of Normal-to-Normal intervals (SDNN) in both short-term assessments (MD = 6.43, p = 0.01) and 24-hour assessments (MD = 10.92, p = 0.004).
Short-term low-frequency power (LF) improved significantly following stress reduction compared to control conditions (MD = 160.11, p < 0.001).

Structured PICO

Do stress-reducing interventions improve heart rate variability in patients with cardiovascular disease?

Population

Patients with cardiovascular disease (CVD)

Intervention

Stress-reducing interventions

Outcome

Biomarkers and time-domain/frequency-domain parameters of heart rate variability (HRV)surrogate

Stress-reducing interventions significantly improve heart rate variability parameters in patients with cardiovascular disease, suggesting a potential mechanism for improved outcomes.

Implication

Stress-reducing interventions improve HRV in CVD; extends trial evidence supporting autonomic-targeted adjunctive strategies.

Abstract

Stress is recognized as a significant trigger and exacerbator of various medical conditions, particularly in the field of cardiovascular disease (CVD). Given that heart rate variability (HRV) offers insight into the functioning of the autonomic nervous system and has been identified as a predictive factor for increased cardiovascular mortality, exploring the correlation between stress and HRV is pertinent. We systematically reviewed trials where researchers investigated the effects of stress-reducing interventions on biomarkers and time-domain/frequency-domain parameters of HRV in CVD. Eligible studies underwent meta-analysis utilizing a random-effects model. The meta-analysis showed overall beneficial effects of stress-reducing interventions on HRV for the standard deviation of Normal-to-Normal intervals (SDNN) in short-term and 24 h assessments, as well as for the low-frequency power (LF) in short-term assessment. Overall effect sizes were notably high and showed significant p-values (short-term SDNN: MD = 6.43, p = 0.01; 24 h SDNN: MD = 10.92, p = 0.004; short-term LF: MD = 160.11, p < 0.001). Our findings highlight the significant impact of stress-reducing interventions in modulating HRV by influencing short-term SDNN and LF parameters, as well as the 24 h assessment of SDNN. These results emphasize the importance of stress-reducing measures in lowering the risk of further progression in CVD and improving patient outcomes.