Abstract
Determination of whether results of cardiovascular reflex tests and spectral analysis of heart rate variability are age dependent and whether there is correlation between results of both, cardiovascular reflex tests (the Valsalva manoeuvre, deep breathing test, handgrip test, cold face stimulus test, orthostatic test) and spectral analysis of heart rate variability were performed on 83 healthy volunteers of both genders, aged 21 to 70 years. We found that results of all heart rate based tests and results of spectral analysis decreased with aging, while results of blood pressure based tests did not. Parasympathetic activity predominated in younger subjects, while in older subjects sympathetic activity was dominant. Valsalva, deep breathing, and orthostatic ratios correlated with integrals of amplitude spectra in the standing posture and deep breathing and cold face stimulus ratios with integrals of amplitude spectra in the supine posture, whereas blood pressure changes during handgrip and orthostatic test did not correlate with integrals of the amplitude spectra. These findings suggest that tests based on heart rate may be more sensitive than tests based on blood pressure changes. This study supports the use of spectral analysis as an additional clinical test of autonomic nervous system function and stresses the importance of age in the evaluation of the results of autonomic nervous system function testing.
Similar content being viewed by others
References
Bannister R, Mathias CJ. Introduction and classification of antrionic disorders. In: Bannister R, Mathias CJ, eds.Autonomic Failure, a Textbook of Clinical Disorders of the Autonomic Nervous System. 3rd ed. Oxford: Oxford University Press, 1992: 1–12.
Ewing DJ. Analysis of heart rate variability and non-invasive tests with diabetes mellitus. In: Bannister R and Mathias CJ, eds.Autonomic Failure, a Textbook of Clinical Disorders of the Autonomic Nervous System. 3rd ed. Oxford: Oxford University Press, 1992: 312–333.
Heath ME, Downey JA. The cold face test (diving reflex) in clinical autonomic assessment: methodological considerations and repeatability of responses.Clin Sci 1990;78: 139–147.
Natelson BH. Neurocardiology. An interdisciplinary area for the 80s.Arch Neurol 1985;42: 178–184.
Akselrod S. Spectral analysis of fluctuations in cardiovascular parameters: a quantitative tool for the investigation of autonomic control.TIPS 1988;9: 6–9.
Weise F, Heydenreich F, Runge U. Contributions of sympathetic and vagal mechanisms to the genesis of heart rate fluctuations during orthostatic load: a spectral analysis.J Auton Nerv Syst 1987;21: 127–134.
Pomeranz B, Macaulay RJB, Caudill MA, Kutz I, Adam D, Gordon D. Assessment of autonomic function in humans by heart rate spectral analysis.Am J Physiol 1985;248: 151–153.
Malliani A, Pagani M, Lombardi F, Cerutti S. Cardiovascular neural regulation explored in the frequency domain.Circulation 1991;84: 482–492.
Malliani A, Pagani M, Lombardi F, Cerutti S. Clinical and experimental appraisal of sympatho-vagal interaction.N Trends arrhythmias 1989;5: 99–105.
Pagani Met al. Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog.Circ Res 1986;59: 178–193.
Pagani Met al. Spectral analysis of heart rate variability in the assessment of autonomic diabetic neuropathy.J Auton Nerv Syst 1988;23: 143–153.
Malliani A, Pagani M, Lombardi F, Furlan R, Guzzetti S, Cerutti S, Spectral analysis to assess increased sympathetic tone in arterial hypertension.Hypertension 1991;17 (Suppl III): III36-III42.
Aharon-Peretz J, Harel T, Revach M, Ben-Haim SA. Increased sympathetic and decreased parasympathetic cardiac innervation in patients with Alzheimer's disease.Arch Neurol 1992;49: 919–922.
Murata K, Landrigan PJ, Araki S. Effects of age, heart rate, gender, tobacco and alcohol ingestion on R-R interval variability in human ECG.J Auton Nerv Syst 1992;37: 199–206.
Cerutti S, Mainardi L, Bianchi A, Signorini MG, Bertinelli M. Time-variant autoregressive spectral estimation in acute ischemic episodes.Proc IEEE Comput Cardiol 1992; 315–318.
Akselrod S, Arbel J, Oz O, Benary V, David D. Spectral analysis of heart rate fluctuations in the evaluation of autonomous control during acute myocardial infarction.Proc IEEE Comput Cardiol 1985: 315–318.
Kiauta T, Jager F, Bjelogrlič Z, Šega S, Grad A. Personal computer-based analysis of heart rate fluctuations in human subjects.Proc IEEE Comput Cardiol 1989: 407–410.
Maayan C, Axelrod FB, Akselrod S, Carley DW, Shannon CD. Evaluation of autonomic dysfunction in familial dysautonomia by power spectral analysis.J Auton Nerv Syst 1987;21: 51–58.
Weise F, Heydenreich F. Age-related changes of heart rate power spectra in diabetic man during orthostasis.Diabetes Res Clin Pract 1991;11: 23–32.
Kleiger RE, Bigger JT, Bosner MSet al. Stability over time of variables measuring heart rate variability in normal subjects.Am J Cardiol 1991;68: 626–630.
Tapp WN, Knox III FS, Natelson BH. The heart rate spectrum in simulated flight: reproducibility and effects of atropine.Aviat Space Environ Med 1990;61: 887–892.
Sands KEF, Appel ML, Lilly LS, Schoen FJ, Mudge GH, Cohen RJ. Power spectrum analysis of heart rate variability in human cardiac transplant recipients.Circulation 1989;79: 76–82.
Xia R, Odemuyiwa O, Murgatroyd F, Gill J, Malik M, Camm AJ. Influence of the artefact of computerized analysis of 24-hour electrocardiograms on the measurement of spectral components of heart rate variability.Proc IEEE Comput Cardiol 1992; 307–310.
Balli E, Casolo GC, Giomi A, Alfieri A, Chiti M, Del Citerna F. Thrombolytic therapy affects the time course of spectral components of heart period variability in anterior wall myocardial infarction.Proc IEEE Comput Cardiol 1992; 311–314.
Moriguchi A, Otsuka A, Kohara Ket al. Spectral change in heart rate variability in response to mental arithmetic before and after the beta-adrenoceptor blocker, carteolol.Clin Auton Res 1992;2: 267–270.
Lipsitz LA, Mietus J, Moody GB, Goldberger AL. Spectral characteristics of heart rate variability before and during postural tilt. Relations to aging and risk of syncope.Circulation 1990;81: 1803–1810.
Cohen A, Biomedical Signal Processing. In:Vol. I. Time and Frequency Domains Analysis. Boca Raton, Florida: CRC Press, Inc., 1986: 65–139.
Karemaker JM. Analysis of blood pressure and heart rate variability: theoretical considerations and clinical applicability. In: Low PA, ed.Clinical Autonomic Disorders. Boston: Little, Brown and Company, 1993: 315–329.
Hayano J, Sakakibara Y, Yamada Aet al. Accuracy of assessment of cardiac vagal tone by heart rate variability in normal subjects.Am J Cardiol 1991;67: 199–204.
Genovely H, Pfeifer MA. RR-variation: the autonomic test of choice in diabetes.Diabetes Metabl Rev 1988;4: 255–271.
Levin AB. A simple test of cardiac function based upon the heart rate changes induced by the Valsalva maneuver.Am J Cardiol 1966;18: 90–99.
De Boer RW, Karemaker JM, Strackee J. Description of heart rate variability data in accordance with a physiological model for the genesis of heartbeats.Psychophysiology 1985;22: 147–155.
Darlington RB. Regression and Linear Models. McGraw-Hill, New York 1990; 134–139.
Kelly J, O'Malley K. Adrenoceptor function and ageing.Clin Sci 1984;66: 509–515.
Green HJ.The Autonomic Nervous System and Exercise. (Lond): Chapman and Hall, 1990: 166–77.
Davies IB, Sever PS. Adrenoceptor function. In: Bannister R, Mathias CJ, eds.Autonomic Failure. A Textbook of Clinical Disorders of the Autonomic Nervous System. 3rd ed. Oxford; Oxford University Press, 1992: 348–366.
Ziegler MG, Lake CR, Kopin PJ. Plasma noradrenaline increases with age.Nature 1976;261: 333–335.
De Marneffe M, Jacobs P, Haardt R, Englert M. Variations of normal sinus node function in relation to age: role of autonomic influence.Eur Heart J 1986;7: 662–672.
O'Brien IAD, O'Hare P, Corrall RJM. Heart rate variability in healthy subjects: effect of age and the derivation of normal ranges for tests of autonomic function.Br Heart J 1986;55: 348–354.
Gautschy B, Weidmann P, Gnadinger MP. Autonomic function tests as related to age and gender in normal man.Klin Wochenschr 1986;64: 499–505.
Low PA. The effect of aging on the autonomic nervous system. In: Low PA, ed.Clinical Autonomic Disorders. Boston; Little, Brown and Company, 1993: 685–700.
Vita G, Princi P, Calabro R. Cardiovascular reflex tests. Assessment of age-adjusted normal range.J Neurol Sci 1986;75: 263–274.
McLeod JG, Tuck RR. Disorders of the autonomic nervous system: Part 2. Investigation and treatment.Ann Neurol 1987;21: 519–529.
Robbe HWJ, Mulder LJM, Ruddel H, Langewitz WA, Veldman JBP, Mulder G. Assessment of baroreceptor reflex sensitivity by means of spectral analysis.Hypertension 1987;10: 538–543.
Desai T, Collins J, Biaggioni I, Shiavi R, Haile V, Robertson D. Effects of meals on heart rate spectra.Proc, 12th Annu Int Conf IEEE Eng Med Biol Soc, Philadelphia, PA, 1990; 755–756.
Simpson DM, Wicks R. Spectral analysis of heart rate indicates reduced baroreceptor-related heart rate variability in elderly persons.J Gerontol 1988;43: M21-M24.
Shannon DC, Carley DW, Benson H. Aging of modulation of heart rate.Am J Physiol 1987;253 (Heart Circ Physiol 22): H874-H877.
Lindqvist A, Jalonen J, Parviainen P, Antila K, Laitinen LA. Effect of posture on spontaneous and thermally stimulated cardiovascular oscillations.Cardiovasc Res 1990;24: 373–380.
Hirsch JA, Bishop B. Respiratory sinus arrhythmia in humans: how breathing pattern modulates heart rate.Am J Physiol 1981;241 (Heart Circ Physiol 10): H620-H629.
Piha SJ, Puuka P, Seppanen A. Short- and long-term reproducibility of cardiovascular tests of autonomic function in normal subjects.Clin Auton Res 1991;1: 115–118.
Freeman R, Saul JP, Roberts MS, Berger RD, Broadbridge C, Cohen RJ. Spectral analysis of heart rate in diabetic autonomic neuropathy. A comparison with standard tests of autonomic function.Arch Neurol 1991;48: 185–190.
Ewing DJ, Martyn CN, Young RJ, Clarke BF. The value of cardiovascular autonomic function tests: 10 years experience in diabetes.Diabetes Care 1985;8: 491–498.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Šega, S., Jager, F. & Kiauta, T. A comparison of cardiovascular reflex tests and spectral analysis of heart rate variability in healthy subjects. Clinical Autonomic Research 3, 175–182 (1993). https://doi.org/10.1007/BF01826230
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01826230