Heart rate variability characteristics in sedentary postmenopausal women following six months of exercise training: the DREW study

Conrad P Earnest, Carl J Lavie, Steven N Blair, Timothy S Church, Conrad P Earnest, Carl J Lavie, Steven N Blair, Timothy S Church

Abstract

Background: Decreased heart rate variability (HRV) is associated with a higher risk of mortality. Overall, postmenopausal women have lower levels of HRV than premenopausal women, which may be additionally complicated by lifestyle related behaviors such as physical inactivity and obesity. Though cardiorespiratory exercise training increases HRV, little is known regarding the exercise dose necessary to promote this improvement.

Methodology/principal findings: Our primary aim was to measure HRV in post-menopausal women following 6-months of exercise training. We examined supine resting HRV in 373 post-menopausal women (45-75 y) after 6-months of randomly assigned and double-blinded administered exercise training exercise training at 50%, 100% and 150% of the NIH Consensus Development Panel's recommended minimal physical activity level. This corresponded to 4, 8, or 12 kcal/kg per week (KKW) of energy expenditure. At baseline, we observed no significant differences in HRV or hormone replacement use between treatment groups. However, we did observe that Caucasian women and those taking antidepressant medications had lower levels of baseline HRV. After 6-months of exercise intervention, we observed a dose dependent increase in all parasympathetically derived time and frequency domain measurements across exercise groups after adjustment for age, ethnicity, antidepressants, and baseline rMSSD (all, P<0.001). For example, the parasympathetic index rMSSD was greater than control (23.19+/-1.0) for the 4-KKW (25.98+/-0.8; P = 0.14), 8-KKW (27.66+/-1.0; P<0.05), and 12-KKW (27.40+/-0.0; P<0.05) groups at follow-up.

Conclusions/significance: Moderate intensity exercise training exercise is sufficient to improve HRV in previously sedentary postmenopausal women in a dose-dependent manner, as 4-KKW is insufficient to improve parasympathetic indices of HRV, while 12-KKW conferred no greater improvement than 8-KKW.

Trial registration: Clinicaltrials.gov NCT 00011193.

Trial registration: ClinicalTrials.gov NCT00011193.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. DREW Heart Rate Variability Assessment:…
Figure 1. DREW Heart Rate Variability Assessment: Schematic diagram represents CONSORT flow chart of the DREW heart rate variability study analysis.

References

    1. Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Eur Heart J. 1996;17:354–381.
    1. Algra A, Tijssen JG, Roelandt JR, Pool J, Lubsen J. Heart rate variability from 24-hour electrocardiography and the 2-year risk for sudden death. Circulation. 1993;88:180–185.
    1. Brockbank CL, Chatterjee F, Bruce SA, Woledge RC. Heart rate and its variability change after the menopause. Exp Physiol. 2000;85:327–330.
    1. Carnethon MR, Golden SH, Folsom AR, Haskell W, Liao D. Prospective investigation of autonomic nervous system function and the development of type 2 diabetes: the Atherosclerosis Risk In Communities study, 1987–1998. Circulation. 2003;107:2190–2195.
    1. Tsuji H, Venditti FJ, Jr, Manders ES, Evans JC, Larson MG, et al. Reduced heart rate variability and mortality risk in an elderly cohort. The Framingham Heart Study. Circulation. 1994;90:878–883.
    1. Mosca L, Manson JE, Sutherland SE, Langer RD, Manolio T, et al. Cardiovascular disease in women: a statement for healthcare professionals from the American Heart Association. Writing Group. Circulation. 1997;96:2468–2482.
    1. Eaker ED, Chesebro JH, Sacks FM, Wenger NK, Whisnant JP, et al. Cardiovascular disease in women. Circulation. 1993;88:1999–2009.
    1. Physical activity and cardiovascular health. NIH consensus development panel on physical activity and cardiovascular health. JAMA. 1996;276:241–246.
    1. Church TS, Earnest CP, Skinner JS, Blair SN. Effects of different doses of physical activity on cardiorespiratory fitness among sedentary, overweight or obese postmenopausal women with elevated blood pressure: a randomized controlled trial. JAMA. 2007;297:2081–2091.
    1. Lucini D, Milani RV, Costantino G, Lavie CJ, Porta A, et al. Effects of cardiac rehabilitation and exercise training on autonomic regulation in patients with coronary artery disease. Am Heart J. 2002;143:977–983.
    1. Schuit AJ, van Amelsvoort LG, Verheij TC, Rijneke RD, Maan AC, et al. Exercise training and heart rate variability in older people. Med Sci Sports Exerc. 1999;31:816–821.
    1. Davy KP, Willis WL, Seals DR. Influence of exercise training on heart rate variability in post-menopausal women with elevated arterial blood pressure. Clin Physiol. 1997;17:31–40.
    1. Myslivecek PR, Brown CA, Wolfe LA. Effects of physical conditioning on cardiac autonomic function in healthy middle-aged women. Can J Appl Physiol. 2002;27:1–18.
    1. Perini R, Fisher N, Veicsteinas A, Pendergast DR. Aerobic training and cardiovascular responses at rest and during exercise in older men and women. Med Sci Sports Exerc. 2002;34:700–708.
    1. Reland S, Ville NS, Wong S, Senhadji L, Carre F. Does the level of chronic physical activity alter heart rate variability in healthy older women? Clin Sci (Lond) 2004;107:29–35.
    1. Jurca R, Church TS, Morss GM, Jordan AN, Earnest CP. Eight weeks of moderate-intensity exercise training increases heart rate variability in sedentary postmenopausal women. Am Heart J. 2004;147:e21.
    1. Morss GM, Jordan AN, Skinner JS, Dunn AL, Church TS, et al. Dose Response to Exercise in Women aged 45–75 yr (DREW): design and rationale. Med Sci Sports Exerc. 2004;36:336–344.
    1. Huikuri HV, Seppanen T, Koistinen MJ, Airaksinen J, Ikaheimo MJ, et al. Abnormalities in beat-to-beat dynamics of heart rate before the spontaneous onset of life-threatening ventricular tachyarrhythmias in patients with prior myocardial infarction. Circulation. 1996;93:1836–1844.
    1. Huikuri HV, Linnaluoto MK, Seppanen T, Airaksinen KE, Kessler KM, et al. Circadian rhythm of heart rate variability in survivors of cardiac arrest. Am J Cardiol. 1992;70:610–615.
    1. Bertel O, Buhler FR, Kiowski W, Lutold BE. Decreased Beta-adrenoreceptor responsiveness as related to age, blood pressure, and plasma catecholamines in patients with essential hypertension. Hypertension. 1980;2:130–138.
    1. Jones PP, Christou DD, Jordan J, Seals DR. Baroreflex buffering is reduced with age in healthy men. Circulation. 2003;107:1770–1774.
    1. Fluckiger L, Boivin JM, Quilliot D, Jeandel C, Zannad F. Differential effects of aging on heart rate variability and blood pressure variability. J Gerontol A Biol Sci Med Sci. 1999;54:B219–224.
    1. Schwartz JB, Gibb WJ, Tran T. Aging effects on heart rate variation. J Gerontol. 1991;46:M99–106.
    1. Evans JM, Ziegler MG, Patwardhan AR, Ott JB, Kim CS, et al. Gender differences in autonomic cardiovascular regulation: spectral, hormonal, and hemodynamic indexes. J Appl Physiol. 2001;91:2611–2618.
    1. Kuo TB, Lin T, Yang CC, Li CL, Chen CF, et al. Effect of aging on gender differences in neural control of heart rate. Am J Physiol. 1999;277:H2233–2239.
    1. Dickhuth HH, Lehmann M, Auch-Schwelk W, Meinertz T, Keul J. Physical training, vegetative regulation, and cardiac hypertrophy. J Cardiovasc Pharmacol. 1987;10(Suppl 6):S71–78.
    1. Ekblom B, Kilbom A, Soltysiak J. Physical training, bradycardia, and autonomic nervous system. Scand J Clin Lab Invest. 1973;32:251–256.
    1. Katona PG, McLean M, Dighton DH, Guz A. Sympathetic and parasympathetic cardiac control in athletes and nonathletes at rest. J Appl Physiol. 1982;52:1652–1657.
    1. Lewis SF, Nylander E, Gad P, Areskog NH. Non-autonomic component in bradycardia of endurance trained men at rest and during exercise. Acta Physiol Scand. 1980;109:297–305.
    1. Dixon EM, Kamath MV, McCartney N, Fallen EL. Neural regulation of heart rate variability in endurance athletes and sedentary controls. Cardiovasc Res. 1992;26:713–719.
    1. Levy WC, Cerqueira MD, Harp GD, Johannessen KA, Abrass IB, et al. Effect of endurance exercise training on heart rate variability at rest in healthy young and older men. Am J Cardiol. 1998;82:1236–1241.
    1. Shin K, Minamitani H, Onishi S, Yamazaki H, Lee M. Autonomic differences between athletes and nonathletes: spectral analysis approach. Med Sci Sports Exerc. 1997;29:1482–1490.
    1. Yataco AR, Fleisher LA, Katzel LI. Heart rate variability and cardiovascular fitness in senior athletes. Am J Cardiol. 1997;80:1389–1391.
    1. Davy KP, Miniclier NL, Taylor JA, Seals DR Stevenson exercise training. Elevated heart rate variability in physically active postmenopausal women: a cardioprotective effect? Am J Physiol. 1996;271:H455–460.
    1. American College of Sports Medicine Position Stand. Exercise and physical activity for older adults. Med Sci Sports Exerc. 1998;30:992–1008.
    1. Westerterp KR, Meijer EP. Physical activity and parameters of aging: a physiological perspective. J Gerontol A Biol Sci Med Sci. 2001;56 Spec No 2:7–12.
    1. Britton A, Shipley M, Malik M, Hnatkova K, Hemingway H, et al. Changes in Heart Rate and Heart Rate Variability Over Time in Middle-Aged Men and Women in the General Population (from the Whitehall II Cohort Study). Am J Cardiol. 2007;100:524–527.
    1. Ito H, Ohshima A, Tsuzuki M, Ohto N, Yanagawa M, et al. Effects of increased physical activity and mild calorie restriction on heart rate variability in obese women. Jpn Heart J. 2001;42:459–469.
    1. Blair SN, Kohl HW, 3rd, Barlow CE, Paffenbarger RS, Jr, Gibbons LW, et al. Changes in physical fitness and all-cause mortality. A prospective study of healthy and unhealthy men. JAMA. 1995;273:1093–1098.
    1. Blair SN, Kohl HW, 3rd, Paffenbarger RS, Jr, Clark DG, Cooper KH. Physical fitness and all-cause mortality. A prospective study of healthy men and women. JAMA. 1989;262:2395–2401.
    1. Arai Y, Saul JP, Albrecht P, Hartley LH, Lilly LS, et al. Modulation of cardiac autonomic activity during and immediately after exercise. Am J Physiol. 1989;256:H132–141.
    1. Furlan R, Piazza S, Dell'Orto S, Gentile E, Cerutti S, et al. Early and late effects of exercise and athletic training on neural mechanisms controlling heart rate. Cardiovasc Res. 1993;27:482–488.
    1. Hull SS, Jr, Vanoli E, Adamson PB, Verrier RL, Foreman RD, et al. Exercise training confers anticipatory protection from sudden death during acute myocardial ischemia. Circulation. 1994;89:548–552.
    1. La Rovere MT, Bersano C, Gnemmi M, Specchia G, Schwartz PJ. Exercise-induced increase in baroreflex sensitivity predicts improved prognosis after myocardial infarction. Circulation. 2002;106:945–949.
    1. La Rovere MT, Mortara A, Sandrone G, Lombardi F. Autonomic nervous system adaptations to short-term exercise training. Chest. 1992;101:299S–303S.
    1. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, et al. Physical Activity and Public Health. Updated Recommendation for Adults From the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116:1081–1093.
    1. Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, et al. Physical Activity and Public Health in Older Adults. Recommendation From the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116:1094–1105.

Source: PubMed

Sponsor e collaboratori

Condizioni mediche

Interventi farmacologici

3
Sottoscrivi