Update: factors influencing heart rate variability-a narrative review

Area of Science:

• Physiology
• Autonomic Nervous System
• Health Markers

Background:

• Heart rate variability (HRV) serves as a crucial non-invasive marker for assessing autonomic physiological regulatory pathways.
• Diminished HRV is linked to increased mortality, highlighting its clinical significance.
• HRV is susceptible to a wide array of influencing factors and diseases.

Purpose of the Study:

• To provide a comprehensive overview of factors influencing HRV.
• To elucidate the significance of these factors for accurate HRV interpretation.
• To consolidate current knowledge on HRV modulation.

Main Methods:

• A narrative review approach was employed.
• Inclusion criteria focused on reviews, meta-analyses, and cohort studies published up to 2021.
• Identified HRV confounders were systematically categorized into four groups: non-influenceable physiological factors, diseases, influenceable lifestyle factors, and external factors.

Main Results:

• HRV reduction was observed across non-influenceable physiological factors (age, gender, ethnicity).
• Numerous acute and chronic diseases (e.g., psychiatric disorders, myocardial infarction, heart failure) were associated with decreased HRV.
• Influenceable lifestyle factors (alcohol abuse, overweight, physical activity) and external factors (heat, noise, shift work, hazardous substances) also demonstrated a significant impact on HRV.

Conclusions:

• Accurate interpretation of HRV necessitates consideration of numerous influencing factors.
• Future diagnostic and workplace HRV measurements should account for identified confounders to mitigate data bias.
• Integrating confounder assessment into health promotion strategies can enhance the quality and reliability of HRV studies.