Heart rate variability in patients with anxiety disorders: A systematic review and meta‐analysis

Abstract

Aims Patients with anxiety disorders (AD) have been found to have lower heart rate variability (HRV) than healthy individuals in some studies, but this was inconsistent. Furthermore, the influence of distinct diagnoses, study design, and demographic factors on the results was not comprehensively examined. Methods We gathered studies comparing HRV in patients with AD and in healthy controls. The parasympathetic activity in the hierarchical order principle was adopted in the main analysis. We adopted the random effects model to calculate the standardized mean difference. Results Of the 7805 screened studies, 99 were included in the quantitative analysis, with a total of 4897 AD patients and 5559 controls finally entered the meta‐analysis. AD patients had a significantly lower resting‐state HRV for parasympathetic activity compared to control (Hedges' g = −0.3897). For the diagnostic subgroup analysis relative to the controls, resting‐state HRV was significantly lower in post‐traumatic stress disorder, panic disorder, generalized anxiety disorder, and social anxiety disorder patients. HRV reactivity (all reactivity data, data on physiological challenge, and psychological challenge) did not show significant inter‐group differences between AD patients and healthy subjects. Conclusions The results supported that patients with AD had significantly lower resting‐state HRV than the healthy population, but no alterations were found for HRV reactivity.

The association between heart rate variability and skin conductance: a correlation analysis in healthy individuals and patients with somatic symptom disorder comorbid with depression and anxiety

“…A similar viewpoint has been mentioned in other studies. 8,38 Although low HRV (vagal based, such as HF, RMSSD and SDNN) has been reported in patients with depression, anxiety and somatic symptoms in metaanalyses, the effect sizes were usually low to medium. 13,39 Therefore, in studies with a low sample size, HRV between these patients and healthy individuals was often not significantly different.…”

Prevalence and effects of sleep-disordered breathing on middle-aged patients with sedative-free generalized anxiety disorder: A prospective case-control study

“…In addition, heart rate variability (HRV) is a physiological phenomenon of variation in the time interval between heartbeats. According to previous studies, patients with GAD may have lower resting-state HRV for parasympathetic activity (14), and patients with SDB may have reduced total HRV in resting HRV measurement (15-17). However, no previous studies have examined the role of HRV in the correlation between GAD and SDB.…”

Eye-movement indices of arousal predict ADHD and comorbid externalizing symptoms over a 2-year period

“…Blunted autonomic nervous system (ANS) reactivity is seen in children with externalizing symptoms 48,[51][52][53] , but it is debated whether this is best explained by the externalizing symptoms per se or by their overlap with ADHD 19 . Increased autonomic reactivity and hyperarousal has been reported in internalizing disorders, although results are heterogeneous and differ between methods and tasks 42,49,[52][53][54] .…”