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Anxiety Disorders are Associated with Reduced Heart Rate Variability: A Meta-Analysis

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Authors
John Chalmers, Daniel Quintana, Maree J. Abbott, Andrew H. Kemp
Journal
Frontiers in Psychiatry
Year
2014
Citations
1,027

TL;DR

This meta-analysis found that people diagnosed with anxiety disorders consistently have lower heart rate variability (HRV) compared to healthy individuals, suggesting that tracking and improving your HRV might be a useful strategy if you experience anxiety.

What they tested

This study was a meta-analysis, which means it didn't conduct a new experiment but rather systematically reviewed and combined the results of many existing studies. The researchers tested the association between having an anxiety disorder and a physiological marker called Heart Rate Variability (HRV).

Specifically, they compared:

**Intervention/Exposure:** Individuals who had received a primary diagnosis of an anxiety disorder (such as Panic Disorder, Post-Traumatic Stress Disorder, Generalized Anxiety Disorder, Social Anxiety Disorder, or Obsessive-Compulsive Disorder).

**Comparator:** Healthy individuals who did not have a psychiatric diagnosis.

**Outcome Measures:** The primary outcome was **Heart Rate Variability (HRV)**, which refers to the natural fluctuations in the time intervals between successive heartbeats. HRV is considered an important indicator of autonomic nervous system function, particularly the activity of the parasympathetic nervous system (often called the "rest and digest" system, mediated by the vagus nerve). Higher HRV is generally associated with better health and greater psychological resilience.

The specific HRV measures examined fell into two main categories:

**High Frequency (HF) HRV:** This is a frequency domain measure that primarily reflects parasympathetic nervous system activity (vagal tone).

**Time Domain (TD) HRV:** These are measures calculated from the raw heart beat intervals. The researchers prioritized the Root Mean Square of Successive Differences (RMSSD) because it is highly correlated with HF HRV and closely represents parasympathetic activity. Other time domain measures included the Standard Deviation of NN intervals (SDNN), the percentage of successive NN intervals that differ by more than 50 ms (pNN50), and the Standard Deviation of the Average NN intervals (SDANN).

Who was studied

The meta-analysis synthesized data from **36 individual scientific articles**.

**Sample Size:** These articles collectively included data from **2086 patients** diagnosed with an anxiety disorder and **2294 healthy control individuals**.

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