Men exhibited a significantly longer mean RR interval (SMD 0.57) and higher overall heart rate variability compared to women during 24-hour ECG recordings.
Meta-Analysis (n=4,592)
Does female sex compared to male sex affect day and night heart rate variability indices on 24-h ECG recordings in healthy individuals?
Healthy women exhibit a shorter mean RR interval, lower variability in time domain indices, and higher normalized high-frequency power compared to men on 24-h ECG recordings, with differences more pronounced at night.
Standardized Mean Difference: 0.57 (95% CI 0.38–0.75)
p-value: p=<0.001
PURPOSE: Increasing evidence demonstrates that gender-related factors, and not only biological sex, are relevant in the physiological and pathophysiological mechanisms of the cardiovascular system, including the cardiac autonomic regulation. Sex and gender may also affect daytime and night-time cardiac autonomic control. This meta-analysis aimed to provide a comparison between healthy women and men on heart rate variability using 24-h ECG recordings pointing out sex- and gender-related factors. METHODS: A systematic search was conducted to include studies focusing on both sex and gender differences related to heart rate variability indices in the time and frequency domains. Descriptive data were extracted by two independent reviewers. For each index, standardized mean differences with 95% confidence intervals were computed and a pooled estimate using a fixed- or random-effects model was applied. RESULTS: Twenty-seven studies were included in the meta-analysis. The results showed that only seven studies reported some information about gender-related factors. Concerning sex-related differences, women had a shorter mean RR interval and lower variability of the time domain indices than men. Sex-related differences concerning frequency domain indices were more evident during night-time compared to daytime. CONCLUSION: The characterization of gender-related factors in the study of heart rate variability using 24-h ECG recordings is still sporadic and underexplored. The meta-analysis results could not conclusively support a significant increase of high frequency power in women, although women showed a reduced total power and low frequency to high frequency ratio. There is a strong need for considering heart rate variability in relation to gender-related variables.
Maria et al. (Fri,) conducted a meta-analysis in Healthy (n=4,592). Male sex vs. Female sex was evaluated on Mean RR interval over 24 hours (SMD 0.57, 95% CI 0.38, 0.75, p=<0.001). Men exhibited a significantly longer mean RR interval (SMD 0.57) and higher overall heart rate variability compared to women during 24-hour ECG recordings.
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