Heart rate variability and its changes over 5 years in older adults

Stein, Phyllis K.
Barzilay, Joshua I.
Chaves, Paulo H. M.
Domitrovich, Peter P.
Gottdiener, John S.

¹Washington University School of Medicine, St Louis, MO, USA
²Kaiser Permanente of Georgia and Emory University School of Medicine, Atlanta, GA, USA
³Johns Hopkins University School of Medicine, Baltimore, MD, USA
⁴University of Maryland School of Medicine, Baltimore, MD, USA

Address correspondence to: Phyllis K. Stein. Tel: (+1) 314 286 1350; Fax: (+1) 314 286 1394. Email: [email protected]

Received 19 March 2008; accepted in revised form 8 October 2008

Age and Ageing 38(2):p 212-218, March 2009.

Purpose

to characterise the association between age, ageing and heart rate variability (HRV) in older individuals, 585 adults age >65 years with two 24-h Holter recordings in the Cardiovascular Health Study were studied.

Methods

heart rate (HR), ventricular premature contractions (VPCs), atrial premature contractions (APCs), frequency-domain, ratio-based and non-linear HRV and heart rate turbulence (HRT) were examined cross-sectionally by 5-year age groups and prospectively over 5 years. Analyses adjusted for gender, lower versus elevated cardiovascular (CV) risk and for the change in CV risk.

Results

HR declined, and VPCs and APCs increased per 5-year increase in age. Frequency-domain HRV decreased more at 65–69, less at 70–74 and minimally at ≥75 years, independent of CVD risk or change in CVD risk. Ratio and non-linear HRV continued to decline to ≥75 years old. Ratio HRV and HRT slope were more strongly related to CVD risk than frequency-domain HRV.

Conclusions

cardiac autonomic function, assessed by frequency-domain HRV, declines most at 65–70 and levels off at age >75. The decline is independent of CVD risk or change in CVD risk. Ratio-based and non-linear HRV and HRT slope continued to change with increasing age and were more closely related to CVD risk than frequency-domain HRV.