Key result
Metabolic disorders link to autonomic imbalance and reduced HRV across early to overt stages.
Why the study?
Heart rate variability (HRV) may provide complementary information on autonomic alterations in cardiometabolic disorders, motivating a synthesis of evidence on its role across disease progression and as an early marker of cardiometabolic risk.
Does heart rate variability assessment identify autonomic nervous system alterations and cardiometabolic risk in patients with metabolic disorders?
Does heart rate variability assessment identify autonomic nervous system alterations and cardiometabolic risk in patients with metabolic disorders?
Heart rate variability alterations—specifically reduced parasympathetic parameters (SDNN, RMSSD, pNN50, HF) and increased sympathetic markers (LF, LF/HF ratio)—are detectable even at early subclinical stages of obesity, dyslipidemia, hypertension, and type 2 diabetes, making HRV a promising adjunctive tool for cardiometabolic risk stratification.
Introduction Heart rate variability (HRV) is a non-invasive method for assessing autonomic nervous system function that plays an important role in physiological regulation and may provide complementary information on autonomic alterations associated with cardiometabolic disorders. Aim To summarize current scientific evidence on the role of HRV alterations in major metabolic disorders and also to identify common autonomic patterns across different stages of cardiometabolic disease progression and evaluate the potential role of HRV as an early marker of cardiometabolic risk. Material and methods A narrative review of clinical studies on HRV in patients with cardiometabolic disorders (obesity, dyslipidemia, hypertension, type 2 diabetes mellitus (T2DM)) was performed. Literature was searched in PubMed, Scopus, Web of Science, and Google Scholar using relevant keywords, mainly covering the last five years. Results and discussion Metabolic disorders are characterized by autonomic imbalance with predominance of sympathetic activity and reduced parasympathetic tone. This is reflected by decreased SDNN, RMSSD, pNN50, and HF, along with increased LF and LF/HF ratio. These changes have been reported at early subclinical stages and are associated with blood pressure, glycemia, insulin resistance, lipid profile, and anthropometric parameters. Comorbid conditions are associated with more pronounced HRV reduction and progressive autonomic dysregulation. Conclusions The findings of this review suggest that HRV alterations may represent a potential marker of metabolic disorders and a promising adjunctive tool for cardiometabolic risk stratification, early diagnosis, and monitoring of metabolically associated diseases.
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Teslenko et al. (2026) conducted a review in Cardiometabolic disorders (obesity, dyslipidemia, arterial hypertension, type 2 diabetes mellitus). Cardiometabolic disorders (obesity, dyslipidemia, hypertension, type 2 diabetes mellitus) vs. Normometabolic / healthy controls was evaluated on Heart Rate Variability (HRV) time-domain (SDNN, RMSSD, pNN50) and frequency-domain (LF, HF, LF/HF) parameters. Metabolic disorders are consistently associated with autonomic imbalance showing decreased SDNN, RMSSD, pNN50, and HF, alongside increased LF and LF/HF ratio across early to overt disease stages.
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