Key result
Posttraumatic stress disorder is associated with significantly reduced resting high-frequency heart rate variability (Hedges' g -1.58) and RMSSD (Hedges' g -1.96) compared to healthy controls.
Why the study?
Autonomic nervous system functions indexed by heart rate variability are affected by psychology and physiology, prompting a summary of studies comparing HRV parameters between individuals with PTSD and healthy controls.
Does posttraumatic stress disorder (PTSD) reduce resting heart rate variability compared to healthy controls?
Meta-Analysis (n=1,375)
Does posttraumatic stress disorder (PTSD) reduce resting heart rate variability compared to healthy controls?
Standardized Mean Difference: -1.58 (95% CI -2.32–-0.84)
p-value: p=<0.0001
PTSD is associated with significantly reduced high-frequency HRV and RMSSD, indicating decreased parasympathetic function and altered autonomic nervous system regulation.
PTSD signals parasympathetic withdrawal on HRV; supports autonomic dysregulation but remains hypothesis-generating for interventions.
OBJECTIVE: The functions of both the central and peripheral autonomic nervous system, indexed by heart rate variability (HRV), are affected by psychology and physiology. This review summarizes the results of studies comparing the evaluation of HRV parameters between individuals with posttraumatic stress disorder (PTSD) and healthy controls. METHODS: Eligible studies (n=499) were identified through literature searches of the EMBASE, Medline, PubMed and Web of Science databases. Nineteen studies met our inclusion criteria. A random effects model was used, and standardized mean differences for highfrequency HRV(HF-HRV), low-frequency HRV(LF-HRV) and the root mean square of successive R-R interval differences (RMSSD) were calculated. RESULTS: Significant effects were found for HF-HRV [p<0.0001, Z=4.18; Hedges'g=-1.58, 95% confidence interval (CI) (-2.32, -0.84); k=14] and RMSSD [p<0.00001, Z=4.80; Hedges'g=-1.96, 95% CI (-2.76, -1.16); k=9] relative to healthy controls. Considerable heterogeneity was revealed, but the main effects for HF-HRV and RMSSD were robust in subsequent meta-regression and subgroup analyses. CONCLUSION: Given the relationships among low vagal state, inflammation, and alterations in brain structure and function, including executive function and emotion regulation, reduced HRV may be regarded as an endophenotype in PTSD research.
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Ge et al. (2020) conducted a meta-analysis in Posttraumatic stress disorder (n=1,375). Posttraumatic stress disorder vs. Healthy controls was evaluated on High-frequency heart rate variability (HF-HRV) (Hedges' g -1.58, 95% CI -2.32, -0.84, p=<0.0001). Posttraumatic stress disorder is associated with significantly reduced resting high-frequency heart rate variability (Hedges' g -1.58) and RMSSD (Hedges' g -1.96) compared to healthy controls.
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