Relation of High Heart Rate Variability to Healthy Longevity

Published:February 22, 2010DOI:
      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.
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      Linked Article

      • Erratum for Zulfiqar U, et al. “Relation of High Heart Rate Variability to Healthy Longevity” Am J Cardiol 2010;105:1181–1185
        American Journal of CardiologyVol. 106Issue 1
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          Affiliations should have read Usman Zulfiqar, MDa,c, Donald A. Jurivich, DOa, Weihua Gao, PhDd, and Donald H. Singer, MDb,e
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      • Heart Rate Variability and Longevity
        American Journal of CardiologyVol. 106Issue 6
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          In their recent report “Relation of High Heart Rate Variability to Healthy Longevity,” Zulfiqar et al1 calculated 4 standard 24-hour time-domain measures of heart rate variability by decade in 344 healthy subjects aged 10 to 99 years. In this cross-sectional study, the investigators observed a sharp increase in the root mean square of the successive normal sinus RR interval difference (rMSSD) and the percentage of successive normal sinus RR intervals >50 ms (pNN50) in the 20 subjects aged >80 years.
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      • Holter Heart Rate Variability: Are We Measuring Physical Activity?
        American Journal of CardiologyVol. 106Issue 3
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          We congratulate Zulfiqar et al1 for their valuable study demonstrating the relation between high heart rate (HR) variability and healthy longevity. In their report, they discussed HR variability due to autonomic control and nothing else. HR variability obviously is caused by autonomic control, as demonstrated by autonomic blockade (see, e.g., Figure 1 in Tan et al2). Fluctuation of a variable is caused by control mechanisms in steady-state conditions. Control mechanisms, including baroreflex, detect any blood pressure drift and change HR, with a delay to compensate for the drift.
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