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Autonomic Function Following Concussion in Youth Athletes: An Exploration of Heart Rate Variability Using 24-hour Recording Methodology
Published on: September 21, 2018
How to measure heart rate?
C Ulrich Vogel1, Christian Wolpert, Martin Wehling
1Institute of Clinical Pharmacology, University Hospital of Mannheim, Faculty of Clinical Medicine Mannheim, University of Heidelberg, 68135 Mannheim, Germany.
Insights
Accurate heart rate measurement is crucial for predicting cardiovascular risk. However, studies often fail to report standardized measurement conditions, losing valuable data. Standardization is recommended for reliable heart rate assessments.
Area of Science:
- Cardiology
- Clinical Research Methodology
Background:
- Heart rate is a reliable predictor of cardiovascular morbidity and mortality.
- Accurate measurement conditions are critical for valid heart rate data, similar to blood pressure.
- Previous research indicates potential inconsistencies in how heart rate is measured.
Purpose of the Study:
- To evaluate the accuracy and reporting of conditions during heart rate measurements in clinical trials.
- To identify the extent to which standardized criteria for heart rate determination are met in published research.
Main Methods:
- A systematic review of 56 clinical trials published between 1996-2001 from the Medline database was conducted.
- Studies were identified using search terms "heart rate" and "rest" or "resting".
- Five key conditions influencing heart rate measurement were assessed: resting period, patient posture, environmental factors, recording method, and data analysis.
Main Results:
- On average, only 1.7 out of 5 critical criteria for accurate heart rate measurement were reported in the included studies.
- Information regarding resting periods and environmental conditions was notably absent in most studies.
- This lack of detail compromises the scientific rigor and interpretability of heart rate data.
Conclusions:
- Heart rate, a vital risk predictor, is not reported with sufficient scientific rigor in many clinical trials.
- Standardizing the definition, control, and performance of heart rate measurements is essential.
- Adopting standardized protocols, analogous to blood pressure measurement, can enhance data quality and clinical utility.
Objective:
Heart rate has been shown to predict cardiovascular morbidity and mortality in a very reliable and easily accessible manner. The exact definition of the conditions under which heart rate is measured appears to be as crucial as the determinations of blood pressure or plasma catecholamines. It was investigated how accurately heart rate measurements were performed, and conditions were described in 56 studies identified from prominent journals within the Medline database: (a) search phrases were "heart rate" and "rest" or "resting"; (b) publication date was from 1996 to 2001; and (c) publication type was "clinical trial".
Methods:
Five conditions were considered as most influential: (a) resting period before measurement; (b) posture of the patient; (c) environmental conditions such as temperature or visual and acoustic stimuli; (d) method used to record heart rate; and (e) data analysis, i.e., derivation from raw data. An average of only 1.7 of those 5 criteria for the determination of heart rate were met in the studies included. Information on conditions of, for example, resting period, or environmental conditions is almost completely lacking.
Results And Conclusion:
The data show that a very important risk predictor and treatment target heart rate-is not reported in a scientifically sufficient manner, even in large trials. Valuable information is lost despite the fact that the investment of adequately defining, controlling, and performing this determination is modest in comparison to the potential gain. It is recommended to standardize heart rate measurements in analogy to that of blood pressure determinations.
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