Comparison of cardiac vagal activity between pre and postmenopausal women using heart rate recovery
Background: Ageing is associated with an increase in Heart Rate Recovery (HRR). HRR is a property of vagal activity. But there is little evidence regarding the extent to which age-related changes in HRR depend on simultaneous transition from pre-menopausal state to postmenopausal state. The purpose of this study was (i) to compare HRR between pre and postmenopausal women, (ii) to compare heart rate recovery between men of age group 40-45 years and 45-50years respectively (iii) and to determine whether difference in age, gender and body composition could account for the difference in HRR between pre- and post-menopausal groups.
Methods: HRR was assessed using modified Bruce exercise protocol. The body mass index was assessed by measuring weight and height of the subject. Data was analyzed after adjusting for age and body composition.
Results: It was found that the HRR were significantly higher (P <0.001) in postmenopausal women compared to that of premenopausal women. Analysis after adjusting for age and gender revealed that men of same age group didn’t undergo much change in HRR as compared to women.Conclusions: The study concludes that both ageing and declined oestrogen levels are associated with the increased Hear Rate Recovery (HRR) seen among postmenopausal women.
Robert A. Bruce, Frank W. Lovejoy Jr., Raymond Pearson. Normal respiratory and circulatory pathways of adaptation in exercise. J Clin Invest. 1949 Nov;28 (6 Pt 2):1423-30.
Fletcher GF, Balady GJ, Amsterdam AE, Chaitman B, Eckel R, Fleg J, et al. Exercise standards for testing and training. A statement for health care professionals from the American heart association. Circulation. 2001;104:1694-740.
Savonen KP, Lakka TA, Laukkanen JA. Heart rate response during exercise test and cardiovascular mortality in middle-aged men. Eur Heart J. 2006;27:582-8.
Cole CR, Foody JM, Blackstone EH, Lauer MS. Heart rate recovery after submaximal exercise testing as a predictor of mortality in cardiovascularly healthy cohorts. Ann Intern Med. 2000;132:552-5.
Cole CR, Blackstone EH, Pashkow FJ, Snader CE, Lauer MS. Heart rate recovery immediately after exercise as a predictor of mortality. N Eng J Med. 1999;341:1351-7.
Pierpont GL, Stolpman DR, Gornick CC. Heart rate recovery as an index of parasympathetic activity. J Auton Nerv Syst. 2000;80:169-74.
Shetler S, Marcus R, Froelicher VF, Vora S, Kalisetti D, Prakash M, et al. Heart rate recovery: validation and methodologic issues. J Am Coll Cardiol. 2001;38:1980-7.
Arai Y, Saul JP, Albrecht P, Hartley LH, Lilly LS, Cohen RJ, et al. Modulation of cardiac autonomic activity during and immediately after exercise. J Appl Physiol. 1998;256:H132-41.
Ribeiro TF, Azevendo GD, Crescencio JC, Maraes VR, Papa V, Catai AM, et al. Heart rate variability under resting conditions in post-menopausal and young women. Braz J Med Biol Res. 2001;34:871-7.
Dahlberg ST. Gender differences in the risk factors for sudden cardiac death. Cardiology. 1990;77:31-40.
Rosano MCG, Patrizi R, Leonardo F, Ponikowski P, Collins P, Sarrel PM, et al. Effect of estrogen replacement therapy on heart rate variability and heart rate in healthy postmenopausal women. Am J Cardiol. 1997;80:815-7.
Durnin JVGA, Womersely J. Body fat assessed from total body density and its estimation from skinfold thickness measurements on 481 men and women aged from 16-72 years. Br J Nutr. 1974;32:77-97.
Bruce RA. Multi-stage treadmill test of maximal and sub maximal exercise. In: Bruce RA, eds. Exercise Testing and Training of apparently Health Individuals: A handbook for physicians. USA: American Heart Assoc.;1972: 1-40.
Pollock ML, Foster C, Schmidt D, Hellman C, Linnerud AC, Ward A. Comparative analysis of physiologic responses to three different maximal graded exercise test protocols in healthy women. Am Heart J. 1982;103(3):363-73.
Cole CR, Foody JM, Blackstone EH, Lauer MS. Heart rate recovery after submaximal exercise testing as a predictor of mortality in a cardiovascularly healthy cohort. Ann Intern Med. 2000;132:552-5.
16. Dewey FE, Freeman JV, Engel G, Oviedo R, Abrol N, Ahmed N, et al. Novel predictor of prognosis from exercise stress testing: heart rate variability response to the exercise treadmill test. Am Heart J. 2007;153:281-8.
Gautam S, Shankar N, Tandon OP, Goel N. Comparison of cardiac autonomic functions among postmenopausal women with and without hormone replacement therapy, and premenopausal women. Indian J Physiol Pharmacol. 2011 Oct-Dec;55(4):297-303.
Moodithaya SS, Avadhany ST. Comparison of cardiac autonomic activity between pre and post-menopausal women using heart rate variability. Indian J Physiol Pharmacol. 2009 Jul-Sep;53(3):227-34.