Relation of High Heart Rate Variability to Healthy Longevity

doi:10.1016/j.amjcard.2009.12.022

The American Journal of Cardiology

Volume 105, Issue 8, 15 April 2010, Pages 1181-1185

https://doi.org/10.1016/j.amjcard.2009.12.022 Get rights and content

The population's aging underscores the need to understand the process and define the physiologic markers predictive of healthy longevity. The findings that aging is associated with a progressive decrease in heart rate variability (HRV), an index of autonomic function, suggests that longevity might depend on preservation of autonomic function. However, little is known about late life changes. We assessed the relation between autonomic function and longevity by a cross-sectional study of HRV of 344 healthy subjects, 10 to 99 years old. The HRV was determined from 24-hour Holter records, using 4 time domain measures of HRV (the root mean square of the successive normal sinus RR interval difference [rMSSD], percentage of successive normal sinus RR intervals >50 ms [pNN50], standard deviation of all normal sinus RR intervals during a 24-hour period [SDNN], and standard deviation of the averaged normal sinus RR intervals for all 5-minute segments [SDANN]). Autonomic modulation of the 4 measures differs, permitting distinctions between changes in HRV–parasympathetic function, using rMSSD and pNN50, and HRV–sympathetic function using SDNN and SDANN. Decade values were compared using analysis of variance and t-multiple comparison testing. The HRV of all measures decreases rapidly from the second to fifth decades. It then slows. The HRV–sympathetic function continues to decrease throughout life. In contrast, the decrease in HRV–parasympathetic function reaches its nadir in the eighth decade, followed by reversal and a progressive increase to higher levels (p <0.05), more characteristic of a younger population. In conclusion, healthy longevity depends on preservation of autonomic function, in particular, HRV–parasympathetic function, despite the early age-related decrease. The eighth decade reversal of the decrease in HRV–parasympathetic function and its subsequent increase are key determinants of longevity. Persistently high HRV in the elderly represents a marker predictive of longevity.

Section snippets

Methods

A total of 344 healthy subjects, aged 10 to 99 years (159 males and 185 females), were recruited to the present study. Of the 344 subjects, 221 were outpatients who had gone to the physician's office for a routine medical evaluation; 12 were healthy elderly subjects from assisted living communities; and 111 were healthy volunteers (30 from the Chicago and Elk Grove area and 81 from northern California).

Healthy subjects were defined as those without clinical evidence of organic disease. Oral

Results

Table 1 lists the mean values for the HRV ± SD of healthy subjects across 9 decades determined using the 4 time domain measures. The patterns of age-related changes in HRV were measure dependant.

The HRV–PF, determined using rMSSD and pNN50, exhibited a rapid and precipitous decrease, in a quadratic regression pattern with aging, particularly from the second to fifth decades (correlation coefficient, r = −0.58 for rMSSD and pNN50; Figure 1 and Table 1). However, the decrease in HRV–PF slowed,

Discussion

The findings of the present cross-sectional study have revealed a new pattern of age-related changes in autonomic function, defined in terms of the 4 time domain measures of HRV,1, 8 in a healthy elderly population, supporting the hypothesis that longevity depends on maintenance of good autonomic function, particularly HRV–PF, in the face of age-related decreases.

Differences in autonomic modulation of the HRV measures6, 7 facilitate distinctions between the changes in HRV–PF and HRV–SF. The

Acknowledgment

We thank Ken Umetani, MD, Yamanashi University, Yamanashi, Japan, and Jatupol Kositsawat, MD, University of Illinois at Chicago College of Medicine, Chicago, Illinois, for their help with the initial aspects of our study and with the development of the study database; Rollin McCraty, PhD, and Mike Atkinson, Institute of Heart Math, Boulder Creek, California, for their help with the development of the study database, and Ruth Singer, Maleeha Zulfiqar, MBBS, and Fatima Babar, MD, for their

References (23)

K. Umetani et al.
Twenty-four hour time domain heart rate variability and heart rate: relations to age and gender over nine decades
J Am Coll Cardiol
(1998)
G. Piccirillo et al.
Power spectral analysis of heart rate in subjects over a hundred years old
Int J Cardiol
(1998)
R.E. Kleiger et al.
And the multicenter post-infarction research group: decreased heart rate variability and its association with increased mortality after acute myocardial infarction
Am J Cardiol
(1987)
R.E. Kleiger et al.
Time domain measurements of heart rate variability
Cardiol Clin
(1992)
M.A. Pfeifer et al.
Differential changes of autonomic nervous system function with age in man
Am J Med
(1983)
O.V. Korkushko et al.
Autonomic control of cardiac chronotropic function in man as a function of age: assessment of power spectral analysis of heart rate variability
J Auton Nerv Syst
(1991)
D.H. Singer et al.
Low heart rate variability and sudden cardiac death
J Electrocardiol
(1988)
A.D. Krahn et al.
Diminishing proportional risk of sudden death with advancing age: implications for prevention of sudden death
Am Heart J
(2004)
M. Reardon et al.
Changes in heart rate variability with age
PACE
(1996)
G. Paolisso et al.
Baseline heart rate variability in healthy centenarians: differences compared with aged subjects (>75 years old)The Biochemical and the Medical Research Society
Clin Sci
(1999)

D.J. Ewing et al.

New method for assessing cardiac parasympathetic activity using 24 hour electrocardiograms

Br Heart J

(1984)

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MiscellaneousRelation of High Heart Rate Variability to Healthy Longevity

Section snippets

Methods

Results

Discussion

Acknowledgment

J Am Coll Cardiol

Int J Cardiol

Am J Cardiol

Cardiol Clin

Am J Med

J Auton Nerv Syst

J Electrocardiol

Am Heart J

Changes in heart rate variability with age

PACE

Baseline heart rate variability in healthy centenarians: differences compared with aged subjects (>75 years old)The Biochemical and the Medical Research Society

Clin Sci

New method for assessing cardiac parasympathetic activity using 24 hour electrocardiograms

Br Heart J

Miscellaneous
Relation of High Heart Rate Variability to Healthy Longevity