Resting heart rate and cardiac autonomic tone during passive head-up tilt: a cross-sectional study in 569 subjects without cardiovascular diseases
Abstract Background Resting heart rate (HR) and its variability (HRV) reflect cardiac sympathovagal balance that can stimulated by head-up tilting. HRV is significantly influenced by the level of HR, but how much HRV offers additional information about cardiac autonomic tone than HR alone remains unresolved. We examined the relation of resting HR with short term HRV during passive head-up tilt.Methods Hemodynamics of 569 subjects without medications with direct cardiovascular effects and known cardiovascular diseases were recorded using whole-body impedance cardiography, continuous radial pulse wave analysis and electrocardiography based HRV analysis in supine and upright positions. For statistical analyses the study population was divided into tertiles of resting heart rate according to sexes.Results Higher low frequency to high frequency ratio (LF/HF) of HRV (reflecting sympathovagal balance) was associated with higher HR in supine (p<0.001) and upright positions (p=0.008). The outcome was similar when the HRV analysis was based on HR instead of RR-intervals (p<0.001 supine, p=0.012 upright). The lowest HR tertile presented with higher supine to upright increase in LF/HF than the highest HR tertile (1.1 vs. 0.85, respectively, p=0.037).Conclusion Higher resting HR is related to higher LF/HF in supine and upright positions, reflecting higher cardiac sympathovagal balance. Lower resting HR is associated with lower resting LF/HF, but with a more pronounced increase in both HR and LF/HF during head-up tilt, suggesting greater change cardiac sympathovagal balance in response to upright posture.