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Cardiovagal Tone in Generalised Anxiety Disorder: A Case Control Study.

Anu Priya¹, Sarvesh Malaki¹, Pallavi Abhilasha¹

¹Department of Psychiatry, Christian Medical College, Ludhiana, IND.

|March 18, 2026

Summary

This summary is machine-generated.

Newly diagnosed generalized anxiety disorder (GAD) patients show impaired cardiovagal tone, indicating reduced parasympathetic activity. This autonomic dysfunction may increase cardiovascular risk and signal early brain-heart axis disruption.

Keywords:

autonomic dysfunction cardiovagal tone cardiovascular risk ewing’s battery generalised anxiety disorder heart rate variability parasympathetic regulation

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Reducing State Anxiety Using Working Memory Maintenance

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Published on: July 19, 2017

Area of Science:

Cardiology
Neurology
Psychiatry

Background:

Generalized anxiety disorder (GAD) is linked to autonomic nervous system (ANS) dysfunction.
Impaired cardiovagal tone, a measure of parasympathetic activity, is associated with emotional dysregulation and cardiovascular risks in GAD.
Ewing's battery provides a non-invasive method to assess parasympathetic autonomic function.

Purpose of the Study:

To comprehensively evaluate cardiovagal tone in treatment-naive GAD patients using Ewing's tests.
To compare cardiovagal function between newly diagnosed GAD patients and healthy controls.

Main Methods:

A cross-sectional case-control study involving 40 GAD patients and 40 age/sex-matched healthy controls.
Diagnosis of GAD confirmed using DSM-5 criteria.
Assessment of cardiovagal tone via Ewing's battery: heart rate response to deep breathing (HRDB), expiration:inspiration (E:I) ratio, Valsalva ratio, and 30:15 ratio during head-up tilt test (HUT).

Main Results:

GAD patients exhibited significantly lower HRDB and E:I ratios compared to controls, indicating reduced parasympathetic activity.
No significant differences were found in the Valsalva ratio or 30:15 ratio between groups.
Findings suggest early, subclinical autonomic imbalance in GAD, specifically affecting cardiovagal function.

Conclusions:

Treatment-naive GAD patients demonstrate significant cardiovagal dysfunction, evidenced by reduced heart rate variability and E:I ratio.
Impaired cardiovagal tone is a potential independent risk factor for adverse cardiovascular outcomes.
This dysfunction may serve as a physiological marker for early brain-heart axis disruption in GAD.