Variables Influencing Heart Rate

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Abstract

In both physiologic and pathological conditions, instantaneous heart rate value is the result of a rather complex interplay. It constantly varies under the influence of a number of factors: nonmodifiable and modifiable ones. Pharmacologic blockade with β-adrenergic antagonists and/or with parasympathetic antagonists such as atropine have permitted the identification of the mechanisms of autonomic nervous regulation of heart rate in a variety of physiologic and pathological conditions. The analysis of heart rate and blood pressure variability has yielded additional information on the autonomic control of the circulation, which has proven to have diagnostic and prognostic implications in a number of clinically relevant conditions such as hypertension, acute myocardial infarction, heart failure, and predisposition to sudden cardiac death. This article will summarize, based on available epidemiologic and clinical studies, the key variables influencing heart rate and heart rate variability in view of the known association between heart rate and cardiovascular disease.

Section snippets

Age

With advancing age, the variation shown by resting heart rate in healthy subjects remains a matter of controversy, whereas a decrease in maximal heart rate has been repeatedly reported.3 Resting heart rate has been shown by most of the studies to progressively decline with aging.3, 4, 5, 6, 7 Such change has been shown to be similar (0.13 beats/y) when the effects of several confounders were removed by multivariate analysis in data coming from a cardiovascular survey,5 from the general

Influence of circadian cycle

Neurohormonal factors, posture, and level of physical activity are mainly responsible for the circadian variations of heart rate.3 Heart rate is generally lower during sleep compared with waking periods,24 the difference, irrespective of age, being about 14 beats/min.25 Recently, in a cohort of 3957 patients referred for ambulatory blood pressure monitoring,24 heart rate value during sleep, and, in particular, the absence of sleep-related decrease in heart rate were related to all-cause

Statement of Conflict of Interest

All authors declare that there are no conflicts of interest.

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