Heart rate variability in healthy subjects: effect of age and the derivation of normal ranges for tests of autonomic function.

O'Brien, I.A.D.; O'Hare, Paul; Corrall, R. J. M.

doi:10.1136/hrt.55.4.348

Cited by 444 publications

(261 citation statements)

References 32 publications

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“…This association was both statistically and clinically significant for LF power and EI difference and appropriate sex-specific reference values were given. Also, the association between measures of autonomic function and age is consistent with previous findings [8,9,10,11,12,13], although we found slightly lower associations with age. This could be attributable to the older age of our subjects compared to previous studies.…”

Section: Discussionsupporting

confidence: 92%

“…These Ewing test measures, and also HRV and BRS measures, are based on the autonomically mediated response of the heart rate to changes in blood pressure. Autonomic function has been reported to decrease in relation to age [8,9,10,11,12,13] and to differ between men and women [9,14,15]. Furthermore, diabetic patients have lower values on the Ewing battery [3,16,17,18,19], of the spectral analysis of HRV [4,16,20,21], and have a low BRS [5,22] in comparison with normal glucose tolerant control subjects.…”

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confidence: 99%

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Measures of cardiovascular autonomic nervous function: agreement, reproducibility, and reference values in middle age and elderly subjects

et al. 2003

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Aims/hypothesis. Currently, three categories of cardiovascular autonomic nervous function measures are used: classic Ewing-test measures, measures of heartrate variability (HRV), and measures of baroreflex sensitivity (BRS). Little is known about the agreement between these measures, and reference and reproducibility values for these measures have not been reported within the same group. Methods. As part of the Hoorn Study, 631 subjects aged 50 to 75 participated in a study of autonomic nervous function. Cardiac cycle duration (RR interval) and continuous finger arterial pressure were measured under three conditions: during spontaneous breathing, during six deep breaths over 1 min, and during an active change in position from lying to standing. From these readings, ten measures of autonomic function were assessed (mean heart rate, three Ewing test measures, five HRV measures and one BRS measure). Results. Regression analysis in a healthy subgroup (n=191) showed sex differences for two of the ten measures and seven measures decreased with age. Therefore, appropriate age-specific and sex-specific reference values were calculated. Reproducibility (n=39) of most measures was moderate, with a reliability coefficient of around 50%. Agreement between the measures of autonomic nervous function varied greatly, between 0% and 87%. The HRV-power ratio measure and the blood pressure changes in the lyingto-standing test showed the lowest agreement with all other measures. Conclusion/Interpretation. This study provides agespecific and sex-specific reference values for a wide range of different autonomic function measures in an elderly population. Agreement among the different measures varied widely and reproducibility was only moderate. [Diabetologia (2003) 46:330-338] Keywords Aging, agreement, baroreflex, diabetes mellitus, heart-rate variability, nervous system, autonomic, reference values, reproducibility.

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Section: Discussionsupporting

confidence: 92%

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confidence: 99%

Measures of cardiovascular autonomic nervous function: agreement, reproducibility, and reference values in middle age and elderly subjects

et al. 2003

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“…In the oldest subjects the low HF NUs did not depend on decreased HF power but on the markedly decreased LF power (Tables 2 and 3). [32][33][34][35] The decrease in HF power agrees with Lipsitz's finding of an age-related decline in a spectral measure analysis. 11 A further comparison of autonomic nervous system activity indexes in elderly normotensive and hypertensive patients and the age-matched subjects of our control group 28 showed a similarity between standard and detected values.…”

Section: Discussionsupporting

confidence: 79%

Spectral analysis of heart rate variability in elderly non-dipper hypertensive patients

et al. 1999

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To assess by autoregressive model the frequency domain heart rate variability (HRV) during clinostatism and after passive orthostatic load (head-up tilt), 81 hypertensive and normotensive subjects (42 men and 39 women) were subdivided into four groups: 20 adult normotensive subjects (Group 1); 21 elderly normotensive subjects (Group 2); 20 elderly hypertensive subjects with nocturnal blood pressure (BP) falls (Group 3); and 20 elderly hypertensive subjects without nocturnal BP falls (Group 4). They were chosen to assess the influence of aging and arterial hypertension on sympatheticparasympathetic balance. The age-related decrease observed in nearly all HRV spectral frequency components (normalised units [NUs], high frequency [HF] and low frequency [LF]) was reported in elderly patients in rest conditions. LF indexes resulted in decreases in Group 3 and these data seemed to be emphasised in

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“…Autonomic function was investigated performing a battery of standard cardiovascular (CV) tests, previously described and currently used for the diagnosis of diabetic autonomic neuropathy [15][16][17][18]: (i) heart rate variation during deep breathing (DB) at 6 cycles/min; (ii) heart rate variation with postural change: (a) lying to standing test (LS) and (b) the increase in heart rate during the first 15 s after standing (SHR); (iii) heart rate variation to a standard Valsalva manoeuvre; (iv) postural blood pressure (PBP) test. Each test was performed by means of a computerized method (Autocheck 'r' 3, vers.…”

Section: Assessment Of Autonomic Functionmentioning

confidence: 99%

“…5.1 software; K. Thomaseth and F. Bellavere, Padua, Italy); blood pressure was recorded using a Finapres device (Ohmeda, Denver, CO) for beat to beat blood pressure monitoring. The tests were graded as normal, borderline or abnormal with a score of 0, 1 or 2, respectively, using age-related normal ranges previously published [16,18]. Autonomic dysfunction was defined with a total score Ն 5 [19].…”

Section: Assessment Of Autonomic Functionmentioning

confidence: 99%

Autonomic nervous dysfunction in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA): possible pathogenic role of autoantibodies to autonomic nervous structures

Maule¹,

Quadri²,

Mirante³

et al. 1997

Clinical and Experimental Immunology

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SUMMARYAutonomic nervous dysfunction has been previously reported in SLE, RA and systemic sclerosis, but the pathogenesis of such a complication is poorly understood. In the present study, four standard cardiovascular autonomic function tests were performed in 34 female patients with connective tissue diseases and in 25 healthy control subjects, and results expressed as cardiovascular (CV) test scores. Moreover, in each subject the presence of circulating complement-fixing autoantibodies directed against sympathetic and parasympathetic nervous structures, represented by superior cervical ganglia and vagus nerve, respectively, was simultaneously assessed by an indirect immunofluorescent complement-fixation technique, using rabbit tissue as substrate. None of the patients reported autonomic symptoms. However, an abnormal CV test score (Ն 5) was detected in 15% of the patients and in none of the healthy control subjects, approaching statistical significance (P ¼ 0·07). No correlation was found between CV test results and disease duration, type of therapy or presence of conventional autoantibodies. One or two autoantibodies to autonomic nervous structures were detected in six patients (18%) and not in the control subjects (P < 0·05). Values of deep breathing test were significantly lower in autoantibody-positive patients compared with those amongst the control subjects (P < 0·05), and an abnormal CV test score was significantly associated with the presence of autoantibodies to autonomic nervous structures (P < 0·05). In conclusion, we confirm that autonomic nervous function can be impaired in patients with connective tissue diseases, and suggest that autoantibodies directed against autonomic nervous system structures may play a role in the pathogenesis of the autonomic dysfunction.

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Heart rate variability in healthy subjects: effect of age and the derivation of normal ranges for tests of autonomic function.

Cited by 444 publications

References 32 publications

Measures of cardiovascular autonomic nervous function: agreement, reproducibility, and reference values in middle age and elderly subjects

Measures of cardiovascular autonomic nervous function: agreement, reproducibility, and reference values in middle age and elderly subjects

Spectral analysis of heart rate variability in elderly non-dipper hypertensive patients

Autonomic nervous dysfunction in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA): possible pathogenic role of autoantibodies to autonomic nervous structures

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