Elsevier

American Heart Journal

Volume 138, Issue 3, September 1999, Pages 567-576
American Heart Journal

Effect of exercise training on heart rate variability in healthy older adults,☆☆,,★★

https://doi.org/10.1016/S0002-8703(99)70162-6Get rights and content

Abstract

Objective To determine the effect of exercise training on cardiac autonomic modulation in normal older adults by using analysis of heart rate variability. Subjects The exercise group consisted of 7 men and 9 women aged 66 ± 4 years. The comparison group consisted of 7 men and 9 women also aged 66 ± 4 years. Method Heart rate variability was determined from 24-hour Holter recordings before and after 12 months of supervised exercise, which consisted of 3 months of stretching and 9 months of 5 hours/week aerobic exercise at approximately 70% of maximal oxygen uptake. Heart rate variability was measured at baseline and 12 months later in the comparison group, who had not changed their usual activity level. Results In the exercise group maximal oxygen consumption increased from 1.8 ± 0.5 L/min to 2.2 ± 0.7 L/min (P < .05). The standard deviation of normal interbeat intervals increased from 126 ± 21 ms to 142 ± 25 ms. Mean nighttime heart rate decreased from 67 ± 6 beats/min to 63 ± 5 beats/min. Increased fitness level had little effect on indexes of heart rate variability, which reflect parasympathetic or mixed sympathetic/parasympathetic modulation of heart rate. There was no change in heart rate or heart rate variability in the comparison group. Conclusions Exercise training increases total heart rate variability in normal older adults. The most marked alterations are in nocturnal heart rate. Heart rate variability is stable over a 1-year period in older adults who do not alter their activity level. (Am Heart J 1999;138:567-76.)

Section snippets

Experimental patients

Sixteen adults (7 men and 9 women) aged 66.2 ± 4.2 years completed the exercise part of this study. All patients were participating in a larger project evaluating the cardiovascular effects of exercise in older adults. Subjects were nonsmokers, without evidence of cardiovascular disease by history, cardiac examination, 12-lead electrocardiogram, and treadmill exercise testing. None were taking cardioactive medications and none had engaged in regular exercise for at least 2 years before

Baseline measurement

Initial indexes of heart rate and heart rate variability were compared between the training and comparison groups (no change in activity pattern). No statistically significant differences were observed.

Effect of exercise training on maximum oxygen consumption, maximum heart rate, and ectopy

Exercise training resulted in a marked increase in maximal oxygen consumption, expressed in either liters per minute (22.2%) or mL/kg/min (30.5%) (P < .001). This increase occurred in all patients. Maximal heart rate was not altered (Table I). A trend to a lower supine resting heart rate as

Discussion

The results of this study suggest that in healthy older adults the expected adaptive increase in maximal oxygen consumption in response to exercise training is associated with an increase in longer term indexes of heart rate variability. The clearest change is a decrease in nocturnal mean heart rate. Mean SDNN and SDANN, which reflect the longest term heart rate variability trends, are consequently increased. Low values for SDNN and SDANN have been associated with an increased risk for death

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    From the aDivision of Cardiology, Washington University School of Medicine, bBarnes-Jewish Hospital, and the cDivision of Cardiology and Division of Geriatrics and Gerontology, Washington University School of Medicine, St. Louis; and the dDepartments of Medicine (Cardiology) and Pharmacology, Vanderbilt University School of Medicine, Nashville.

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    Supported in part by the Claude D. Pepper Older American Independence Center NIH Grant AG 13629 and NIH Individual National Research Service Award F32 HL-08538.

    Reprint requests: Phyllis K. Stein, PhD, Division of Cardiology, Barnes-Jewish Hospital, 216 S Kingshighway Blvd, St. Louis, MO 63110. E-mail: [email protected]

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