Heart Rate Variability (HRV)

Heart beats are not perfectly sapced out, Heart Rate Variability (HRV) is the variability in distance between heart beats. Classically it has been measured on EKGs or medical grade devices but most recently a lot of wearable devices like, Oura ring, Whoop or Apple watches are capable of producing acceptable accuracy.

Heart rate variability is a noninvasive method that reflects the balance between both sides of autonomic nervous system, the sympathetic system  ( fight or flight) and parasympathetic system (rest and digest), measured at the level of the sinoatrial node, the natural pacemaker of the heart.

When it comes to the field of Longevity and preventive care it is considered a valuable noninvasive biomarker with specific applications across preventative care, longevity, sleep quality, exercise recovery and VO2 max prediction.

Lower HRV was found to be independently associated with increased risk cardiovascular diseases in general, in both the healthy and the sick, supporting its use  as a risk stratification tool for early identification of individuals at high risk of adverse outcomes, as well as common population, who want to learn more about their bodies, sleep, recovery and how different life events affect their health, and moreover, how can they utilize this tool to predict certain outcomes.

What can lead to a drop HRV?

• Poor sleep quality: Poor sleep quality and conditions like obstructive sleep apnea, lead to a lower HRV. Improving your sleep, fixing your sleep hygiene, and avoiding late meals and alcohol  can lead to improvement in HRV and over all health.
• Over training: When it comes to exercise and training, the lack of recovery, could be as harmful as not exercising at all. Recovery is key. Poor recovery leads to dramatically lower HRV values. A lower HRV, could be a queue to take it easy on training and focus on recovery.
• Alcohol intake: Alcohol intake tends to lower HRV. Nothing good comes out of alcohol. Avoidance of alcohol is beneficial all around.
• Low Vo2 max: Low Vo2 max and low exercise capacity, leads to a generally lower HRV.
• Dehydration: Chronic dehydration is an endemic. People underestimate the amount of water they need per day, and day after day, this leads to chronic dehydration. Low HRV could be one of the first queues to drink more water.
• Acute Illness: Acute illness from a simple respiratory illness, to cardiac event, lead to low HRV. HRV should not be used as a diagnostic tool but as a measure to predict how your body is doing, and to focus on rest and recovery.
• Certain medication: Certain medications, for example beta blockers, lower HRV, so caution should be taken when looking at the HRV while on certain medications.
• Unhealthy eating and life habits: Excess sugar and highly processed food, lead to a lower HRV, due to the inflammatory effect these foods exert on the body. Cleaning up the food choices, leads to better health all around.

• Older age: It is normal for HRV to drop with age, but this is rather a very slow and gradual drop rather than a sudden decrease.
• Psychological stress: stress is an independent risk factor for cardiovascular disease, regardless of the presence of any other risk factors, like smoking or diabetes. It should not be taken lightly and should always be addressed with diligence.
• High Altitude: Sudden change on altitude, like traveling to a ski destination, will lead through various mechanisms to a lower HRV in general.

HRV is best used as an adjunct, a lens, to see how daily choices, stressors, sleep, and recovery habits affect the body for better or worse. The goal isn’t to chase a number; rising HRV is simply a byproduct of better health, fitness, and recovery, which in turn a major stride towards Longevity.