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Age and Ageing Advance Access originally published online on January 15, 2009
Age and Ageing 2009 38(2):212-218; doi:10.1093/ageing/afn292
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© The Author 2009. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Heart rate variability and its changes over 5 years in older adults

Phyllis K. Stein1, Joshua I. Barzilay2, Paulo H. M. Chaves3, Peter P. Domitrovich1 and John S. Gottdiener4

1 Washington University School of Medicine, St Louis, MO, USA
2 Kaiser Permanente of Georgia and Emory University School of Medicine, Atlanta, GA, USA
3 Johns Hopkins University School of Medicine, Baltimore, MD, USA
4 University of Maryland School of Medicine, Baltimore, MD, USA

Address correspondence to: Phyllis K. Stein. Tel: (+1) 314 286 1350; Fax: (+1) 314 286 1394. Email: pstein{at}im.wustl.edu

Purpose: to characterise the association between age, ageing and heart rate variability (HRV) in older individuals, 585 adults age >65 years with two 24-h Holter recordings in the Cardiovascular Health Study were studied.

Methods: heart rate (HR), ventricular premature contractions (VPCs), atrial premature contractions (APCs), frequency-domain, ratio-based and non-linear HRV and heart rate turbulence (HRT) were examined cross-sectionally by 5-year age groups and prospectively over 5 years. Analyses adjusted for gender, lower versus elevated cardiovascular (CV) risk and for the change in CV risk.

Results: HR declined, and VPCs and APCs increased per 5-year increase in age. Frequency-domain HRV decreased more at 65–69, less at 70–74 and minimally at ≥75 years, independent of CVD risk or change in CVD risk. Ratio and non-linear HRV continued to decline to ≥75 years old. Ratio HRV and HRT slope were more strongly related to CVD risk than frequency-domain HRV.

Conclusions: cardiac autonomic function, assessed by frequency-domain HRV, declines most at 65–70 and levels off at age >75. The decline is independent of CVD risk or change in CVD risk. Ratio-based and non-linear HRV and HRT slope continued to change with increasing age and were more closely related to CVD risk than frequency-domain HRV.

Keywords: ageing, autonomic nervous system, heart rate variability, ambulatory ECG, elderly

Received 19 March 2008; accepted in revised form 8 October 2008.


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