Aging, heart rate variability and patterns of autonomic regulation of the heart

Abstract

Objectives: To evaluate the effects of aging, gender and body mass index on the heart rate variability (HRV), and to compare the patterns of global autonomic regulation (GAR) and parasympathetic outflow (PO) throughout the aging process.

Design, setting and participants: CROSS-SECTIONAL: Large sample of community-based adults and elderly people. Individuals aged from 40 to 100 years, functionally independent and with satisfactory cognitive function defined as the self-capacity to interact with an interviewer (N= 1743).

Material and methods: The study enrolled individuals of both genders, stratified into five age-groups. We did adjustments for hypertension, dyslipidemia and non-insulin-dependent diabetes, as well as the body mass index (BMI). All groups undertook long-term electrocardiograms and five time-domain HRV parameters were measured, three (SDNN, SDANN, SDNN-index) reflecting the GAR and two (rMSSD and pNN50) the PO.

Results: SDNN, SDANN and SDNN-index decreased linearly with age and BMI, and women had lower values than men (p<0.001). There was a U-shaped pattern of rMSSD and pNN50, with the nadir between 60 and 69 years for both genders, and women had higher values than men (p<0.001). The lowest levels of all HRV variables were found in diabetics (p<0.001). There was no influence of hypertension or dyslipidemia.

Conclusions: The GAR decreased linearly with the age in both genders. It is comparatively lower in women, diabetics and overweight individuals. The PO presented the U-shape in both genders with the nadir at the 7th decade. It was also comparatively lower in men and diabetics. Hypertension and dyslipidemia imparted no significant influence.

Keywords: Ambulatory electrocardiography; Autonomic nervous system; Health of the elderly; Heart rate variability.