Clinical Autonomic Research

, Volume 15, Issue 4, pp 292–298

Age, body mass index, and menstrual cycle influence young women’s heart rate variability

A multivariable analysis
  • Maite Vallejo
  • Manlio F. Márquez
  • Victor H. Borja-Aburto
  • Manuel Cárdenas
  • Antonio G. Hermosillo


Heart rate variability (HRV) in women has been related independently to endogenous sex hormones, hormone replacement therapy, menopause, menstrual cycle, body mass index (BMI), and physical conditioning. However, the joint influence of all these factors has not been reported. The present study describes the relation between circadian variation HRV and assesses its association with BMI, age, and menstrual cycle in healthy young women. A multivariable analysis was performed to estimate the predictive variables involved in SDNN, pNN50, and rMSSD profile, using the classification and regression tree (CART) and the logistic regression models. It was found that the first predictive variable was age, which divided women in two groups: >29.5 years old and <29.5 years old. In the case of the SDNN, the second predictive variable was BMI; the highest values were observed in women younger than 23 years old, with a BMI less than 19.82 kg/m2 and during the follicular phase of her menstrual cycle. For pNN50 and rMSSD the second predictive variable was menstrual cycle for women younger than 29.5 years old. Thus, in this group of women, age was a major determinant of cardiac autonomic nervous modulation followed by the BMI. HRV may be better understood using a multivariable analysis that could mimic physiological conditions.

Key words

heart rate variability women classification and regression tree (CART) menstrual cycle body mass index (BMI) 


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  1. 1.
    Bonnemeier H, Richardt G, Potratz J, Wiegand UK, Brandes A, Kluge N, et al. (2003) Circadian profile of cardiac autonomic nervous modulation in healthy subjects: differing effects of ageing and gender on heart rate variability. J Cardiovasc Electrophysiol 14(8):791–799CrossRefPubMedGoogle Scholar
  2. 2.
    Breiman L, Frieman JH, Olshen RA, Stone CJ (1984) Classification and regression trees (Wadsworth International Group, Belmont, CAGoogle Scholar
  3. 3.
    Brito-Zurita OR, Posadas-Romero C, Hermosillo AG, Zamora-González J, Hernández-Ono A, Cardoso-Saldaña G, et al. (2003) Estrogen effect on heart rate variability in hypertensive postmenopausal women. Maturitas 44:39–48CrossRefPubMedGoogle Scholar
  4. 4.
    Casu M, Patrone V, Gianelli MV, Marchegiani A, Ragni G, Murialdo G, et al. (2002) Spectral analysis of RR interval variability by short-term recording in anorexia nervosa. Eat Weight Disord 7(3):239–243PubMedGoogle Scholar
  5. 5.
    Dekker JM, Crow RS, Folsom AR, Hannan PJ, Liao D, Swenne CA, et al. (2000) Low heart rate variability in a 2-minute rhythm strip predicts risk of coronary heart disease and mortality from several causes: the ARIC Study. Atherosclerosis risk in communities. Circulation 102(12):1239–1244PubMedGoogle Scholar
  6. 6.
    Ito H, Nozaki M, Maruyama T, Kaji Y, Tsuda Y (2001) Shift work modifies the circadian patterns of heart rate variability in nurses. Int J Cardiol 79(2–3):231–236CrossRefPubMedGoogle Scholar
  7. 7.
    Katz AM (1977) Physiology of the heart. New York. Raven Press, p 296Google Scholar
  8. 8.
    Leicht AS, Hirning DA, Allen GD (2003) Heart rate variability and endogenous sex hormones during the menstrual cycle in young women. Exp Physiol 88(3):441–446CrossRefPubMedGoogle Scholar
  9. 9.
    Myslivecek PR, Brown CA, Wolfe LA (2002) Effects of physical conditioning on cardiac autonomic function in healthy middle-aged women. Can J Appl Physiol 27(1):1–18PubMedGoogle Scholar
  10. 10.
    National Institute of Health, National Heart, Lung and Blood Institute (1998) Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults: the evidence report. Obes Res 6(Suppl 2):51–209sGoogle Scholar
  11. 11.
    Quilliot D, Fluckiger L, Zannad F, Drouin P, Ziegler O (2001) Impaired autonomic control of heart rate and blood pressure in obesity: role of age and of insulin-resistance. Clin Auton Res 11:79–86PubMedGoogle Scholar
  12. 12.
    Ribeiro TF, Azevedo GD, Crescencio JC, Maraes VR, Papa V, Catai AM, et al. (2001) Heart rate variability under resting conditions in postmenopausal and young women. Braz J Med Biol Res 34(7):871–877PubMedGoogle Scholar
  13. 13.
    Sato N, Miyake S, Akatsu J, Kumashiro M (1995) Power spectral analysis of heart rate variability in healthy young women during the normal menstrual cycle. Psychosom Med 57(4):331–335PubMedGoogle Scholar
  14. 14.
    Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart Rate Variability. Standards of measurement, physiological interpretation and clinical use. Circulation 93:1043–1065PubMedGoogle Scholar
  15. 15.
    Umetani K, Singer DH, McCraty R, Atkinson M (1998) Twenty-four hour time domain heart rate variability and heart rate: relations to age and gender over nine decades. J Am Coll Cardiol 31:593–601CrossRefPubMedGoogle Scholar
  16. 16.
    Yildirir A, Kabakci G, Yarali H, Aybar F, Akgul E, Bukulmez O, et al. (2001) Effects of hormone replacement therapy on heart rate variability in postmenopausal women. Ann Noninvasive Electrocardiol 6(4):280–284PubMedGoogle Scholar
  17. 17.
    Yildirir A, Kabakci G, Akgul E, Tokgozoglu L, Oto A (2002) Effects of menstrual cycle on cardiac autonomic innervation as assessed by heart rate variability. Ann Noninvasive Electrocardiol 7(1):60–63PubMedGoogle Scholar
  18. 18.
    Zahorska-Markiewicz B, Kuagowska E, Kucio C, Klin M (1993) Heart rate variability in obesity. Int J Obes Relat Metab Disord 17:21–23PubMedGoogle Scholar

Copyright information

© Steinkopff-Verlag 2005

Authors and Affiliations

  • Maite Vallejo
    • 1
  • Manlio F. Márquez
    • 2
  • Victor H. Borja-Aburto
    • 3
  • Manuel Cárdenas
    • 1
  • Antonio G. Hermosillo
    • 2
  1. 1.Clinical Research DivisionInstituto Nacional de Cardiología Ignacio ChávezTlalpanMéxico
  2. 2.Dept. of ElectrocardiologyInstituto Nacional de Cardiología, Ignacio Chávez Juan Badiano No. 1. Col. Sección XVITlalpan 14080 D. F.México
  3. 3.Occupational Medicine DivisiónInstituto Mexicano del Seguro SocialMéxico, D. F.México

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