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Addleman JS, Lackey NS, DeBlauw JA, Hajduczok AG. Heart Rate Variability Applications in Strength and Conditioning: A Narrative Review. J Funct Morphol Kinesiol 2024; 9:93. [PMID: 38921629 PMCID: PMC11204851 DOI: 10.3390/jfmk9020093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
Heart rate variability (HRV) is defined as the fluctuation of time intervals between adjacent heartbeats and is commonly used as a surrogate measure of autonomic function. HRV has become an increasingly measured variable by wearable technology for use in fitness and sport applications. However, with its increased use, a gap has arisen between the research and the application of this technology in strength and conditioning. The goal of this narrative literature review is to discuss current evidence and propose preliminary guidelines regarding the application of HRV in strength and conditioning. A literature review was conducted searching for HRV and strength and conditioning, aiming to focus on studies with time-domain measurements. Studies suggest that HRV is a helpful metric to assess training status, adaptability, and recovery after a training program. Although reduced HRV may be a sign of overreaching and/or overtraining syndrome, it may not be a sensitive marker in aerobic-trained athletes and therefore has different utilities for different athletic populations. There is likely utility to HRV-guided programming compared to predefined programming in several types of training. Evidence-based preliminary guidelines for the application of HRV in strength and conditioning are discussed. This is an evolving area of research, and more data are needed to evaluate the best practices for applying HRV in strength and conditioning.
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Affiliation(s)
- Jennifer S. Addleman
- College of Osteopathic Medicine, Touro University California, Vallejo, CA 94592, USA
| | - Nicholas S. Lackey
- Center for Applied Biobehavioral Sciences (CABS), Alliant International University, San Diego, CA 92131, USA;
| | - Justin A. DeBlauw
- Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY 12866, USA
| | - Alexander G. Hajduczok
- Department of Cardiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA;
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Christofaro DGD, Tebar WR, Mota J, Delfino LD, Santos AB, Ritti-Dias RM, Fernandes RA, Ferrari G, Vanderlei LCM. Association of Sports Practice in Childhood and Adolescence with Cardiac Autonomic Modulation in Adulthood: A Retrospective Epidemiological Study. SPORTS MEDICINE - OPEN 2024; 10:41. [PMID: 38625654 PMCID: PMC11021389 DOI: 10.1186/s40798-024-00707-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/26/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Practicing sports during childhood and adolescence provides benefits to cardiac autonomic modulation (CAM) at these stages of life. However, it is not known whether these benefits to CAM persist into adulthood. Therefore, the objective of this study was to analyze the association of early sports practice (sports practice in childhood and/or adolescence) with CAM in adult life, regardless of habitual moderate-to-vigorous PA. METHODS The sample of the present study consisted of 242 adults (141 women and 101 men; age: 41.99 ± 16.24). The assessment of CAM was performed using heart rate variability indices. Sports practice in childhood and adolescence was assessed using a questionnaire. The intensity of physical activity was assessed using accelerometry. To analyze the association between previous sports practice (childhood and/or adolescence) and CAM, the Generalized Linear Model was adopted, considering CAM indices as continuous variables and early sports practice as a 3-fold factor (no sports practice; sports practice in childhood or adolescence; and sports practice in both childhood and adolescence) adjusted by sex, age, socioeconomic condition, and moderate to vigorous PA. RESULTS Sports practice in childhood was associated with the average standard deviation of all normal RR intervals expressed in milliseconds (SDNN): β = 5.89; 95%CI: 0.25;11.52, and the standard deviation of the long-term intervals between consecutive heartbeats (SD2): β = 7.63; 95%CI:1.04; 14.23 indices. Sports practice in adolescence was associated in adulthood with the SD2 index: β = 7.37; 95%CI: 0.71;14.04. Sports practice in at least one of the periods (childhood or adolescence) was significantly associated with the square root of the mean square of the differences between adjacent normal RR intervals for a period of time expressed in milliseconds (RMSSD) (β = 8.86; 95%CI = 0.71;17.01), and the standard deviation of the instantaneous beat to beat variability (SD1) (β = 6.21; 95%CI = 0.45;11.97). Sports practice at both stages of life was significantly associated with better SDNN (β = 7.70; 95%CI = 1.16;14.23) and SD2 (β = 10.18; 95%CI = 2.51;17.85). CONCLUSION Early sports practice was associated with better CAM in adulthood, independently of the current physical activity level. Based on these findings, sports practice is encouraged from childhood and adolescence, for benefits to CAM in adult life.
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Affiliation(s)
- Diego Giulliano Destro Christofaro
- School of Technology and Sciences, São Paulo State University (Unesp), Roberto Simonsen Street, n° 305, Presidente Prudente, São Paulo, 19060-900, Brazil.
| | - William R Tebar
- Centre of Clinical and Epidemiological Research, University Hospital, University of Sao Paulo, São Paulo, Brazil
| | - Jorge Mota
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports, University of Porto (FADEUP) and Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Leandro D Delfino
- School of Technology and Sciences, São Paulo State University (Unesp), Roberto Simonsen Street, n° 305, Presidente Prudente, São Paulo, 19060-900, Brazil
| | - Amanda B Santos
- School of Technology and Sciences, São Paulo State University (Unesp), Roberto Simonsen Street, n° 305, Presidente Prudente, São Paulo, 19060-900, Brazil
| | - Raphael M Ritti-Dias
- Graduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, São Paulo, Brazil
| | - Rômulo A Fernandes
- School of Technology and Sciences, São Paulo State University (Unesp), Roberto Simonsen Street, n° 305, Presidente Prudente, São Paulo, 19060-900, Brazil
| | - Gerson Ferrari
- Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Chile
| | - Luiz Carlos M Vanderlei
- School of Technology and Sciences, São Paulo State University (Unesp), Roberto Simonsen Street, n° 305, Presidente Prudente, São Paulo, 19060-900, Brazil
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Alansare AB, Gibbs BB, Holzman C, Jennings JR, Kline CE, Nagle E, Catov JM. Isotemporal Associations of Device-Measured Sedentary Time and Physical Activity with Cardiac-Autonomic Regulation in Previously Pregnant Women. Int J Behav Med 2023; 30:497-508. [PMID: 35819720 PMCID: PMC9832172 DOI: 10.1007/s12529-022-10113-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND High sedentary time (ST) and low physical activity may increase cardiovascular risk, potentially though cardiac-autonomic dysregulation. This study investigated associations of statistically exchanging device-measured ST and physical activity with measures of cardiac-autonomic regulation in previously pregnant women. METHOD This cross-sectional, secondary analysis included 286 women (age = 32.6 ± 5.7 years; 68% white) measured 7-15 years after delivery. ST and light (LPA), moderate (MPA), vigorous (VPA), and moderate-to-vigorous (MVPA) intensity physical activity were measured by ActiGraph GT3X. ST was further partitioned into long (≥ 30 min) and short (< 30 min) bouts. MVPA was also partitioned into long (≥ 10 min) and short (< 10 min) bouts. Cardiac-autonomic regulation was assessed by heart rate variability (HRV) (resting heart rate, natural log transformed standard deviation of normal R-R intervals [lnSDNN], natural log-transformed root mean square of successive differences [lnRMSSD]) from a 5-min seated ECG. Progressive isotemporal substitution models adjusted for confounders. Sensitivity analyses removed women with related underlying medical conditions and who did not meet respiration rate criteria. RESULTS Initial analyses found no significant associations with HRV when exchanging 30 min of ST and physical activity (p > 0.05). Yet, replacing long- and short-bout ST with 30 min of long-bout MVPA yielded significantly higher (healthier) lnRMSSD (B = 0.063 ± 0.030 and B = 0.056 ± 0.027, respectively; both p < 0.05). Sensitivity analyses strengthened these associations and yielded further associations of higher lnSDNN and lnRMSSD when replacing 30 min of short-bout MVPA with equivalent amounts of long-bout MVPA (B = 0.074 ± 0.037 and B = 0.091 ± 0.046, respectively). CONCLUSION Replacing ST with long-bout MVPA is a potential strategy to improve cardiac-autonomic function in previously pregnant women.
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Affiliation(s)
- Abdullah Bandar Alansare
- Department of Exercise Physiology, College of Sport Sciences and Physical Activity, King Saud University, King Khalid Rd, B69-G1 Building, Riyadh, 80200, Saudi Arabia.
| | - Bethany Barone Gibbs
- Department of Health and Human Development, School of Education, University of Pittsburgh, 140 Trees Hall, Pittsburgh, PA, 15261, USA
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, West Virginia, USA
| | - Claudia Holzman
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, 48824, USA
| | - J Richard Jennings
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15219, USA
| | - Christopher E Kline
- Department of Health and Human Development, School of Education, University of Pittsburgh, 140 Trees Hall, Pittsburgh, PA, 15261, USA
| | - Elizabeth Nagle
- Department of Health and Human Development, School of Education, University of Pittsburgh, 140 Trees Hall, Pittsburgh, PA, 15261, USA
| | - Janet M Catov
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, 300 Halket St, Pittsburgh, PA, 15213, USA
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Krause E, Vollmer M, Wittfeld K, Weihs A, Frenzel S, Dörr M, Kaderali L, Felix SB, Stubbe B, Ewert R, Völzke H, Grabe HJ. Evaluating heart rate variability with 10 second multichannel electrocardiograms in a large population-based sample. Front Cardiovasc Med 2023; 10:1144191. [PMID: 37252117 PMCID: PMC10213655 DOI: 10.3389/fcvm.2023.1144191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/27/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Heart rate variability (HRV), defined as the variability of consecutive heart beats, is an important biomarker for dysregulations of the autonomic nervous system (ANS) and is associated with the development, course, and outcome of a variety of mental and physical health problems. While guidelines recommend using 5 min electrocardiograms (ECG), recent studies showed that 10 s might be sufficient for deriving vagal-mediated HRV. However, the validity and applicability of this approach for risk prediction in epidemiological studies is currently unclear to be used. Methods This study evaluates vagal-mediated HRV with ultra-short HRV (usHRV) based on 10 s multichannel ECG recordings of N = 4,245 and N = 2,392 participants of the Study of Health in Pomerania (SHIP) from two waves of the SHIP-TREND cohort, additionally divided into a healthy and health-impaired subgroup. Association of usHRV with HRV derived from long-term ECG recordings (polysomnography: 5 min before falling asleep [N = 1,041]; orthostatic testing: 5 min of rest before probing an orthostatic reaction [N = 1,676]) and their validity with respect to demographic variables and depressive symptoms were investigated. Results High correlations (r = .52-.75) were revealed between usHRV and HRV. While controlling for covariates, usHRV was the strongest predictor for HRV. Furthermore, the associations of usHRV and HRV with age, sex, obesity, and depressive symptoms were similar. Conclusion This study provides evidence that usHRV derived from 10 s ECG might function as a proxy of vagal-mediated HRV with similar characteristics. This allows the investigation of ANS dysregulation with ECGs that are routinely performed in epidemiological studies to identify protective and risk factors for various mental and physical health problems.
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Affiliation(s)
- Elischa Krause
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Vollmer
- Institute of Bioinformatics, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE), Partner Site Rostock/Greifswald, Greifswald, Germany
| | - Antoine Weihs
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Stefan Frenzel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Dörr
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Lars Kaderali
- Institute of Bioinformatics, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Stephan B. Felix
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Beate Stubbe
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Ralf Ewert
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE), Partner Site Rostock/Greifswald, Greifswald, Germany
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Sinha MK, K V, Maiya AG, K N S, U S, N RS. Association of physical activity and heart rate variability in people with overweight and obesity: A systematic review. F1000Res 2023; 12:156. [PMID: 36875496 PMCID: PMC9982191 DOI: 10.12688/f1000research.124707.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/28/2022] [Indexed: 02/12/2023] Open
Abstract
Background: Obesity is a major public health issue globally which is intrinsically linked to reduced heart rate variability (HRV). Physical inactivity and reduced resting HRV are linked to an increased risk of coronary heart disease, while athletes have a greater HRV. However, the exact correlation between physical activity and HRV remains uncertain. This systematic review aims to collect, report, and critically assess the current scientific literature about the association between physical activity and HRV in individuals with higher weight and obesity. Methods: A systematic search was carried out in electronic databases (Medline/PubMed, SCOPUS and CINAHL Plus) to retrieve studies that evaluated the relationship between physical activity and HRV in individuals with higher weight and obesity. Case-control, longitudinal/cohort, cross-sectional and observational studies were included. Using a critical narrative approach, information about the HRV, and physical activity was extracted and synthesized. The study was registered in PROSPERO: CRD42020208018 on October 9 2020. Results: After removing duplicates, 980 title/abstract records were checked for eligibility, and 12 papers were finally included in the narrative synthesis. The included studies contained physical activity as well as HRV in adults with higher weight or obesity with or without comorbidities. A negative relationship between moderate to vigorous physical activity and HRV indices had been found in two studies. There was also a negative relationship between sedentary time and HF (p = 0.049) and LF/HF (p = 0.036), as well as a positive relationship between sedentary time and LF (p = 0.014). Also dose-response association was found between vigorous exercise and higher SDNN, LF power, and HF power in one of the studies. Conclusions: This systematic review revealed a wide range of responses to physical activity and HRV; however, the current evidence uses a variety of approaches to objectively assess physical activity and measure HRV with different equipment.
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Affiliation(s)
- Mukesh Kumar Sinha
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Vaishali K
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Arun G Maiya
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Shivashankar K N
- Department of Medicine, Kasturba Medical college, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Shashikiran U
- Department of Medicine, Dr. TMA Pai Hospital, Udupi, MMMC, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Ravi Shankar N
- Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, Delhi, India
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Physical activity trajectories, autonomic balance and cognitive function: The Coronary Artery Risk Development in Young Adults (CARDIA) study. Prev Med 2022; 164:107291. [PMID: 36209818 DOI: 10.1016/j.ypmed.2022.107291] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 09/27/2022] [Accepted: 10/02/2022] [Indexed: 11/23/2022]
Abstract
Physical activity (PA) plays an important role in cognitive health. However, the underlying mechanisms are not fully understood. Cardiac autonomic balance is influenced by PA and implicated in dementia pathogenesis. We examined whether autonomic balance mediates the association between PA and cognitive function. The sample included 1939 participants from the Coronary Artery Risk Development in Young Adults study who completed cognitive testing after 30-year follow-up (baseline: mean age 25.2 ± 3.5y; 58% women; 43% Black). Moderate to vigorous intensity PA (MVPA) was obtained in 7 consecutive examinations over 20 years (Year 0-Year 20). Cardiac autonomic balance was assessed at Year 20 via resting heart rate (RHR), standard deviation normal to normal (SDNN) and root mean square of successive differences (RMSSD). We used group-based trajectory modeling to identify homogenous MVPA trajectory groups, and formal mediation analysis to test whether autonomic function indices mediate the association between MVPA trajectories and cognition. We identified three distinct PA trajectory patterns: (1) Below MVPA guidelines (n = 1122; 57.9%); (2) Meeting MVPA guidelines (n = 652; 33.6%); and (3) Exceeding MVPA guidelines (n = 165; 8.5%). Meeting and exceeding MVPA guidelines were related to better autonomic balance overall, and to improved semantic fluency performance. Statistically, the association between higher MVPA level and verbal ability was mediated by SDNN and RMSSD, but not by RHR. In our sample of young and middle-aged adults, higher MVPA levels over time were associated with better cardiac autonomic function, which explained some of the associations between PA trajectories and better cognition.
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Oliveira CM, Novelli FI, Alves-Santos ÉT, Queiroz MG, Ghezzi AC, Cambri LT. Physical activity influences heart rate variability in young adults, regardless of dextrose ingestion. Blood Press Monit 2022; 27:220-226. [PMID: 35258021 DOI: 10.1097/mbp.0000000000000593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Cardiac autonomic modulation can be altered by carbohydrate ingestion. On the other hand, some of the protective effects of physical activity may be due to its impact on the autonomic nervous system. PURPOSE This cross-sectional study was conducted to evaluate whether physical activity level influences heart rate variability (HRV) under fasting and mainly, after dextrose ingestion. METHODS Healthy adults aged 18-40 years ( n = 92; 54.35 % women) were separated into nonactive ( n = 47) and active groups ( n = 45), based on the physical activity level determined by International Physical Activity Questionnaire (IPAQ) and then compared. RESULTS There were no significant differences ( P > 0.05) for age, body mass, BMI, abdominal circumference, blood pressure, fasting glucose and blood glucose at 60 min after dextrose ingestion between groups. Body fat (%) was lower in the active group ( P = 0.02). The time-domain indices (RMSSD, SDNN and pNN50) were higher in the physically active group compared to the nonactive group (main effect of group, P < 0.01). The SDNN index was higher at 60 min after dextrose ingestion compared to fasting (main effect of time, P ≤ 0.01). However, no HRV indices showed significantly interaction effect (group x time; P > 0.05). CONCLUSION The magnitude of HRV responses to glucose was not influenced by physical activity status. Young adults who met at least the minimum physical activity recommendations showed a higher cardiac autonomic modulation, regardless of dextrose ingestion.
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Affiliation(s)
| | - Fabiula Isoton Novelli
- Physical Education Department, Graduate Program in Physical Education, Federal University of Mato Grosso, Cuiabá
- Medicine Department, Graduate Program in Sciences, University of São Paulo, São Paulo
| | | | - Marilene Gonçalves Queiroz
- Physical Education Department, Graduate Program in Health Sciences, Federal University of Mato Grosso, Cuiabá
| | | | - Lucieli Teresa Cambri
- Nutrition Department, Graduate Program in Nutrition, Foods and Metabolism
- Physical Education Department, Graduate Program in Physical Education, Federal University of Mato Grosso, Cuiabá
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Brady R, Brown WJ, Hillsdon M, Mielke GI. Patterns of Accelerometer-Measured Physical Activity and Health Outcomes in Adults: A Systematic Review. Med Sci Sports Exerc 2022; 54:1155-1166. [PMID: 35220369 DOI: 10.1249/mss.0000000000002900] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE The aim of this study was to systematically review the literature on accelerometer-measured physical activity and health outcomes in adults. METHODS Eight electronic databases were searched for relevant articles published up to March 2021. Only population-based studies of adults (age ≥18 yr) that directly compared two or more categories of physical activity (i.e., bout duration, intensity, and daily/weekly frequency) with a health outcome (e.g., mortality, cardiometabolic, healthy aging, depression, sleep, and brain structure) were included. RESULTS Of the 15,923 publications retrieved, 52 articles were included. Twenty-eight studies directly compared the associations between physical activity accumulated in different bout durations, 31 studies directly compared the associations between physical activity accumulated in different intensities, and 9 studies directly compared the associations between the effects of varying daily and weekly frequencies of physical activity, with health outcomes. Most showed no differences in relationships with health outcomes when physical activity was accumulated in short (<10-min) or long (≥10-min) bouts. Overall, there were no differences in the relationships with most health outcomes when different intensities and daily/weekly frequencies were compared. However, in most studies, researchers did not adjust their analyses for total volume of physical activity. Moreover, variations in researcher-driven decisions about data collection and processing methods made it difficult to compare study findings. CONCLUSIONS These findings suggest that physical activity accumulated in many patterns of bout duration, intensity, or daily/weekly frequency is associated with a range of beneficial health outcomes in adults. Lack of adjustment for total volume of physical activity in most studies and inconsistent methods for defining components of physical activity prevent firm conclusions about which specific patterns of bout duration, intensity, and daily/weekly frequency are most important for health benefits.
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Affiliation(s)
| | - Wendy J Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, AUSTRALIA
| | - Melvyn Hillsdon
- Sport and Health Sciences, University of Exeter, Devon, UNITED KINGDOM
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Jakob J, Stalder O, Kali T, Pruvot E, Pletcher MJ, Rana JS, Sidney S, Auer R. The Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Med 2022; 135:871-878.e14. [PMID: 35245494 DOI: 10.1016/j.amjmed.2022.01.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Resting heart rate can predict cardiovascular disease. Heart rate increases with tobacco smoking, but its association with cannabis use is unclear. We studied the association between current and cumulative cannabis use and heart rate. METHODS We used data from the Coronary Artery Risk Development in Young Adults (CARDIA) Study, a large prospective cohort of 5115 Black and white women and men followed over 30 years. We explored the association between cannabis exposure and heart rate, adjusted for demographic factors, cardiovascular risk factors, alcohol and other illicit drug use, physical activity, and beta-blockers, in mixed longitudinal models censoring participants with cardiovascular disease. RESULTS CARDIA participants contributed to 35,654 individual examinations over 30 years. At the Year 30 examination, 471 out of 3269 (14%) currently used cannabis. In multivariable adjusted models, compared to no current use, using cannabis 5 times per month was associated with lower heart rate of -0.7 beats per minute (95% confidence interval: -1.0 to -0.3), and daily use with lower heart rate of -2.1 beats per minute (95% confidence interval: -3.0 to -1.3, overall P < .001). Cumulative exposure to cannabis use was not associated with heart rate. CONCLUSION Recent current cannabis use was associated with lower resting heart rate. The findings appeared to be transient because past cumulative exposure to cannabis was not associated with heart rate. This adds to the growing body of evidence suggesting a lack of deleterious association of cannabis use at a level typical of the general population on surrogate outcomes of cardiovascular disease.
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Affiliation(s)
- Julian Jakob
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Department of Pediatrics, University Hospital Bern (Inselspital) Bern, Switzerland.
| | - Odile Stalder
- Clinical Trials Unit (CTU), University of Bern, Bern, Switzerland
| | - Tali Kali
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Etienne Pruvot
- Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Mark J Pletcher
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco; Department of Medicine, University of California San Francisco, San Francisco
| | - Jamal S Rana
- Department of Cardiology, Kaiser Permanente Northern California, Oakland, Calif
| | - Stephen Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland, Calif
| | - Reto Auer
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; University General Medicine and Public Health Centre, University of Lausanne, Lausanne, Switzerland
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Boos CJ, Mellor A, Woods DR, O’Hara JP. The Effect of High-Altitude Acclimatisation on Ultra-Short Heart Rate Variability. Front Cardiovasc Med 2022; 9:787147. [PMID: 35419439 PMCID: PMC8995742 DOI: 10.3389/fcvm.2022.787147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/28/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction High-altitude (HA) exposure affects heart rate variability (HRV) and has been inconsistently linked to acute mountain sickness (AMS). The influence of increasing HA exposure on ultra-short HRV and its relationship to gold standard HRV measures at HA has not been examined. Methods This was a prospective observational study of adults aged ≥ 18 years undertaking a HA trek in the Dhaulagiri region of the Himalayas. Cardiac inter-beat-intervals were obtained from a 10-s recording of supra-systolic blood pressure (Uscom BP+ device) immediately followed by 300 s single lead ECG recording (CheckMyHeart device). HRV was measured using the RMSSD (root mean square of successive differences of NN intervals) at sea level (SL) in the United Kingdom and at 3,619, 4,600, and 5,140 m at HA. Oxygen saturations (SpO2) were measured using finger-based pulse oximetry. The level of agreement between the 10 and 300 s RMSSD values were examined using a modified Bland–Altman relative-difference analysis. Results Overall, 89 participants aged 32.2 ± 8.8 years (range 18–56) were included of which 70.8% were men. HA exposure (SL vs. 3,619 m) was associated with an initial increase in both 10 s (45.0 [31.0–82.0]) vs. 58.0 [33.0–119.0] ms) and 300 s (45.67 [33.24–70.32] vs. 56.48 [36.98–102.0] ms) in RMSSD. Thereafter at 4,600 and 5,140 m both 10 and 300 s RMSSD values were significantly lower than SL. From a total of 317 paired HRV measures the 10 and 300 s RMSSD measures were moderately correlated (Spearman r = 0.66; 95% CI: 0.59–0.72; p < 0.0001). The median difference (bias) in RMSSD values (300 s − 10 s) was −2.3 ms with a lower and upper limit of agreement of −107.5 and 88.61 ms, respectively with no differences with altitude. Overall, 293/317 (92.4%) of all paired HRV values fell within the 95% CI limits of agreement. Neither HRV method was predictive of AMS. Conclusion Increasing HA affects ultra-short HRV in a similar manner to gold-standard 300 s. Ultra-short HRV has a moderate agreement with 300 s measurements. HRV did not predict AMS.
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Affiliation(s)
- Christopher John Boos
- Department of Cardiology, Poole Hospital, University Hospitals Dorset, Poole, United Kingdom
- Department of Postgraduate Medical Education, Bournemouth University, Bournemouth, United Kingdom
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
- *Correspondence: Christopher John Boos,
| | - Adrian Mellor
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
- Defence Medical Services, Lichfield, United Kingdom
- James Cook University Hospital, Middlesbrough, United Kingdom
| | - David Richard Woods
- Defence Medical Services, Lichfield, United Kingdom
- Northumbria NHS Foundation Trust, North Shields, United Kingdom
- Academic Department of Medicine, University of Newcastle, Newcastle upon Tyne, United Kingdom
| | - John Paul O’Hara
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
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Christofaro DGD, Tebar WR, Vanderlei LCM, Fernandes RA, Mota J, Mielke GI, Ritti-Dias RM. Association of cardiac autonomic modulation with different intensities of physical activity in a small Brazilian inner city: a gender analysis. Eur J Sport Sci 2022; 23:649-655. [PMID: 35184676 DOI: 10.1080/17461391.2022.2044913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractPhysical activity has been linked to higher cardiac autonomic modulation. However, it is not clear in the literature which type of intensity of physical activity (sedentary, light, moderate, or vigorous) could be related to better cardiac autonomic modulation and whether this relationship is similar in men and women. The aim of this study was to analyze the relationship between cardiac autonomic modulation and the different intensities of physical activity in men and women. The sample included 100 men and 131 women. Cardiac autonomic modulation was obtained by heart rate variability (SDNN, RMSSD, LF un, HF un, SD1, and SD2). Time spent in different intensities (sedentary, light, moderate, and vigorous intensity physical activity) was measured using a waist-worn accelerometer for seven days. Linear regression was used to verify the relationship between physical activity and cardiac autonomic modulation, considering the adjustment for age, ethnicity, and socioeconomic level. Among men, a significant relationship of moderate intensity was observed with SDNN (β=2.442; p = 0.021) and SD2 (β=2.936, p = 0.028), and of vigorous intensity with SDNN (β=12.826, p = 0.028), RMSSD (β=16.370, p = 0.018), and SD1 (β=12.344, p = 0.025) indices. Among women, light-intensity physical activity was significantly related with LFnu (β= .655, p = 0.005) and HFnu (β= -.590, p = 0.010). Moderate and vigorous physical activity was associated with better cardiac autonomic modulation in men. Light physical activity was associated with lower sympathetic modulation in women.
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Affiliation(s)
- Diego G D Christofaro
- São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, Brazil
| | - William R Tebar
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo (USP), Sao Paulo, Brazil
| | - Luiz Carlos M Vanderlei
- São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, Brazil
| | - Rômulo A Fernandes
- São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, Brazil
| | - Jorge Mota
- Research Center on Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
| | - Gregore I Mielke
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
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12
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Chan A, Chan D, Lee H, Chin Ng C, Hui Ling Yeo A. Reporting adherence, validity and physical activity measures of wearable activity trackers in medical research: A systematic review. Int J Med Inform 2022; 160:104696. [DOI: 10.1016/j.ijmedinf.2022.104696] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 11/19/2021] [Accepted: 01/16/2022] [Indexed: 01/18/2023]
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13
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Cardiac biometric variables and arrhythmic events during COVID-19 pandemic lockdown in patients with an implantable cardiac monitor for syncope work-up. MEDICINA CLINICA (ENGLISH ED.) 2021; 156:496-499. [PMID: 36569267 PMCID: PMC9764422 DOI: 10.1016/j.medcle.2020.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 12/02/2020] [Indexed: 12/27/2022]
Abstract
Aim To assess the changes induced by the COVID-19 lockdown on cardiac biometric variables recorded using an implantable cardiac monitor (ICM) in a patient population monitored for syncope work-up, as well to assess whether there has been an effect on arrhythmic events among the patients. Methods Longitudinal cohort study. We included 245 adult patients monitored with an ICM indicated for the investigation of syncope. The records from days 1 to 12 March 2020 (prior to the institution of lockdown by the state government) with days 16 to 28 March 2020 were compared. Results Daily physical exercise reduced markedly after the imposition of lockdown (132 [55-233] minutes vs. 78 [21-154] minutes). The mean daytime HR prior to lockdown was 77 [69-85] bpm, whereas during lockdown it was 74 [66-81] bpm. During the lockdown period, a drop in the variability in heart rate (114 [94-136] ms vs. 111 [92-133] ms) was observed. Although the incidence of AF was similar over both periods, the daily AF burden was significantly higher post-lockdown (405 [391-425] minutes vs. 423 [423-537] minutes). No differences in the number of other arrhythmias were found. Conclusions The establishment of mandatory lockdown has led to a marked drop in daily physical activity in this population which probably explains changes observed in other cardiac biometric variables. Although, in the short term, we have not documented an increased risk of arrhythmia, we cannot rule out an effect in the medium to long term or in other populations of at-risk patients.
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14
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Francisco-Pascual J, Rivas-Gándara N, Santos-Ortega A, Pérez-Rodón J, Benito B, Belahnech Y, Ferreira-González I. [Cardiac biometric variables and arrhythmic events during COVID-19 pandemic lockdown in patients with an implantable cardiac monitor for syncope work-up]. Med Clin (Barc) 2021; 156:496-499. [PMID: 33642036 DOI: 10.1016/j.medcli.2020.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/30/2020] [Accepted: 12/02/2020] [Indexed: 12/25/2022]
Abstract
AIM To assess the changes induced by the COVID-19 lockdown on cardiac biometric variables recorded using an implantable cardiac monitor (ICM) in a patient population monitored for syncope work-up, as well to assess whether there has been an effect on arrhythmic events among the patients. METHODS Longitudinal cohort study. We included 245 adult patients monitored with an ICM indicated for the investigation of syncope. The records from days 1 to 12 March 2020 (prior to the institution of lockdown by the state government) with days 16 to 28 March 2020 were compared. RESULTS Daily physical exercise reduced markedly after the imposition of lockdown (132 [55-233] minutes vs. 78 [21-154] minutes). The mean daytime HR prior to lockdown was 77 [69-85] bpm, whereas during lockdown it was 74 [66-81] bpm. During the lockdown period, a drop in the variability in heart rate (114 [94-136] ms vs. 111 [92-133] ms) was observed. Although the incidence of AF was similar over both periods, the daily AF burden was significantly higher post-lockdown (405 [391-425] minutes vs. 423 [423-537] minutes). No differences in the number of other arrhythmias were found. CONCLUSIONS The establishment of mandatory lockdown has led to a marked drop in daily physical activity in this population which probably explains changes observed in other cardiac biometric variables. Although, in the short term, we have not documented an increased risk of arrhythmia, we cannot rule out an effect in the medium to long term or in other populations of at-risk patients.
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Affiliation(s)
- Jaume Francisco-Pascual
- Unitat d'Arritmies. Servei de Cardiologia. Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, CIBER-CV, Spain.
| | - Núria Rivas-Gándara
- Unitat d'Arritmies. Servei de Cardiologia. Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, CIBER-CV, Spain.
| | - Alba Santos-Ortega
- Unitat d'Arritmies. Servei de Cardiologia. Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, CIBER-CV, Spain
| | - Jordi Pérez-Rodón
- Unitat d'Arritmies. Servei de Cardiologia. Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, CIBER-CV, Spain
| | - Begoña Benito
- Unitat d'Arritmies. Servei de Cardiologia. Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, CIBER-CV, Spain
| | - Yassin Belahnech
- Unitat d'Arritmies. Servei de Cardiologia. Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, CIBER-CV, Spain
| | - Ignacio Ferreira-González
- Servei de Cardiologia, Hospital Universitari Vall d'Hebron. Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, CIBER-ESP, Spain
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Association between Objective Activity Intensity and Heart Rate Variability: Cardiovascular Disease Risk Factor Mediation (CARDIA)—Erratum. Med Sci Sports Exerc 2020; 52:2060. [DOI: 10.1249/mss.0000000000002449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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