Journal of the American College of Cardiology

Volume 24, Issue 7, December 1994, Pages 1700-1707

Clinical study

Gender- and age-related differences in heart rate

dynamics: Are women more complex than men? ☆
Sheila M. Ryan MD ∗ † 2, Ary L. Goldberger MD, FACC ∗, Steven M. Pincus PhD ∗, Joseph Mietus BS ∗,
Lewis A. Lipsitz MD ∗ † ‡ 1

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https://doi.org/10.1016/0735-1097(94)90177-5
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Abstract
Objectives. This study aimed to quantify the complex dynamics of beat-to-beat sinus rhythm heart rate
fluctuations and to determine their differences as a function of gender and age.

Background. Recently, measures of heart rate variability and the nonlinear “complexity” of heart rate
dynamics have been used as indicators of cardiovascular health. Because women have lower cardiovascular
risk and greater longevity than men, we postulated that there are important gender-related differences in
beat-to-beat heart rate dynamics.

Methods. We analyzed heart rate dynamics during 8-min segments of continuous electrocardiographic
recording in healthy young (20 to 39 years old), middle-aged (40 to 64 years old) and elderly (65 to 90 years
old) men (n = 40) and women (n = 27) while they performed spontaneous and metronomic (15 breaths/
min) breathing. Relatively high (0.15 to 0.40 Hz) and low (0.01 to 0.15 Hz) frequency components of heart
rate variability were computed using spectral analysis. The overall “complexity” of each heart rate time
series was quantified by its approximate entropy, a measure of regularity derived from nonlinear dynamics
(“chaos” theory).

Results. Mean heart rate did not differ between the age groups or genders. High frequency heart rate power
and the high/low frequency power ratio decreased with age in both men and women (p < 0.05). The
high/low frequency power ratio during spontaneous and metronomic breathing was greater in women than
men (p < 0.05). Heart rate approximate entropy decreased with age and was higher in women than men (p <
0.05).
Conclusions. High frequency heart rate spectral power (associated with parasympathetic activity) and the
overall complexity of heart rate dynamics are higher in women than men. These complementary findings
indicate the need to account for genderas well as age-related differences in heart rate dynamics. Whether
these gender differences are related to lower cardiovascular disease risk and greater longevity in women
requires further study.

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Gender- and Age-Related Differences in Heart Rate Dynamics:

Are Women More Complex Than Men?
S H EIL A I-d . R Y A N , M D .*t ARY L. G G L D B E R G E R, M D, F A C C; S T B V FiN M. PI N C U S. P H D.
J O S E P H M I E T U S , B S .” L E W I S A . L I P S I T Z , M D’t S

(2). Becwc dtey dmfop manif&ations of cmdfmucu:iw

discpseal 0 later peelhrn Iheir malecounterparta(2). w o m e n
tend to have hc allhier cmdi-lar function than rimilar-
agedmen t&@wt a dult Me.
Rcantty. I varietyofmzwrss ofhc an rate variltnlity have
been ured PI indic atws of c adiowadar hsllh. A reduction
in bat-tu-be at he an mte wiehile duriy sinvr rhylhm ir
caociuledwith I& (3-12). con&ve he art fanhue(13.14).
eownmy anmy diivc (15,16X portpmndialhypotcwion(17)
(
andsuddenLath wndmma IR.l9I. H-r. little atren6tm
has beenp aid a th-ce&co &,nd’a on hart rak dynamig
Despite the wirksprc ad applic ationof conventtonalme a -
SUES of he art rme variability, tmditionrl indexer bmd on
me anandvurianccpmvkk on!y limited tnfwmation abouithe
intcgmtcddywnirr uf he althyor penmbcdcmdii function.
Additional inform&n qwmti@ing heat-co-beat Ruchmtioos
call be obtainedby Spectralamdy%ir u*i Ly wently drscrited
me arumrderived Imm nontine ardtmuniur (“chaos”theory).
Appmximnb entw is one such PUXWIUIC that provides an
indexd :k “campkxity” of the output of a dynamicpiuce~
(2ll-25). Gre ater mmpkxiiy (irm&rity or unpwdiia!9ility)
of a pmccmmrrayo?ldr w !a q+r approximateentropyvatuer.
Our prwiou~ work (24.26) hu dcamcntcd a declinein the

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References
1. DG Fowles
A profile of older Americans: 1990
(2nd ed), DHHS Publication PF 3029 (1290) D996, American Association of Retired Persons, Administration on
Aging, Washington (DC) (1990), p. 13
Google Scholar

2. WR Hazzard
Biological basis of the sex differential in longevity
J Am Geriatr Soc, 34 (1986), pp. 455-471
View article CrossRef View in Scopus Google Scholar

3. JB Hellman, RW Stacy
Variation of respiratory sinus arrhythmia with age
J Appl Physiol, 41 (1976), pp. 734-738
View article CrossRef View in Scopus Google Scholar

4. JL Waddington, MJ MacCulloch, JE Sambrooks

Resting heart rate variability in man declines with age
Experientia, 35 (1979), pp. 1197-1198
View in Scopus Google Scholar

5. SA Smith
Reduced sinus arrhythmia in diabetic autonomic neuropathy: diagnostic value of an age-
related normal range
Br Med J, 285 (1982), pp. 1599-1601
View article CrossRef View in Scopus Google Scholar

6. JR Jennings, ME Mack
Does aging differentially reduce heart rate variability related to respiration?
Exp Aging Res, 10 (1984), pp. 19-23
View article CrossRef View in Scopus Google Scholar

7. B Gautschy, P Weidmann, MP Gnadinger

Autonomic function tests as related to age and gender in normal man
Klin Wochenschr, 64 (1986), pp. 499-505
View in Scopus Google Scholar

8. IAD O'Brien, P O'Hare, RJM Corrall

Heart rate variability in healthy subjects: effects of age and derivation of normal ranges
for tests of autonomic function
Br Heart J, 55 (1986), pp. 348-354
View article CrossRef View in Scopus Google Scholar

9. DM Simpson, R Wicks
 Spectral analysis of heart rate indicates reduced baroreceptor-related heart rate variability
in elderly persons
J Gerontol, 43 (1988), pp. M21-M24
View article CrossRef View in Scopus Google Scholar

10. LA Lipsitz, J Mietus, GB Moody, AL Goldberger

Spectral characteristics of heart rate variability before and during postural tilt: relations to
aging and risk of syncope
Circulation, 81 (1990), pp. 1803-1810
View in Scopus Google Scholar

11. OV Korkushko, VB Shatilo, JK Kaukenas

Changes in heart rhythm power spectrum during human aging
Aging, 3 (1991), pp. 177-179
View in Scopus Google Scholar

12. JB Schwartz, WJ Gibb, T Tran

Aging effects on heart rate variation
J Gerontol Med Sci, 46 (1991), pp. M99-M106
View article CrossRef Google Scholar

13. JP Saul, Y Arai, RD Berger, LS Lilly, WS Colucci, RJ Cohen

Assessment of autonomic regulation in chronic congestive heart failure by heart rate
spectral analysis
Am J Cardiol, 61 (1988), pp. 1292-1299
View PDF View article View in Scopus Google Scholar

14. G Casolo, E Balli, A Fazi, C Gori, A Freni, G Gensini

Twenty-four hour spectral analysis of heart rate variability in congestive heart failure
secondary to coronary artery disease
Am J Cardiol, 67 (1991), pp. 1154-1158
View PDF View article View in Scopus Google Scholar

15. J Hayano, Y Sakakibara, M Yamada, et al.

Decreased magnitude of heart rate spectral components in coronary artery disease: Its
relation to angiographic severity
Circulation, 81 (1990), pp. 1217-1224
View in Scopus Google Scholar

16. JT Bigger Jr, CA Hoover, RC Steinman, LM Rolnizky, JL Fleiss, The Multiccntcr Study of Silent Myocardial
Ischemia Investigators
Autonomic nervous system activity during myorardial ischemia in man estimated by
power spectral analysis of heart period variability
Am J Cardiol, 66 (1990), pp. 497-498
View PDF View article View in Scopus Google Scholar
17. SM Ryan, AL Goldberger, R Ruthazer, J Mietus, LA Lipsitz
Spectral analysis of heart rate dynamics in elderly persons with postprandial hypotension
Am J Cardiol, 69 (1992), pp. 201-205
View PDF View article View in Scopus Google Scholar

18. GA Myers, GJ Martin, NM Magid, et al.

Power spectral analysis of heart rate variability in sudden cardiac death: comparison with
other methods
IEEE Trans Biomed Eng, 33 (1986), pp. 1149-1156
View in Scopus Google Scholar

19. AI Goldberger, DR Rigney, J Mietus, EM Antman, S Greenwald

Nonlinear dynamics in sudden cardiac death syndrome: heart rate oscillations and
bifucations
Experientia, 44 (1988), pp. 983-987
View in Scopus Google Scholar

20. SM Pincus
Approximate entropy as a measure of system complexity
(2nd ed), Proc Natl Acad Sci USA, 88 (1991), pp. 2297-2301
View article CrossRef View in Scopus Google Scholar

21. SM Pincus, IM Gladstone, RA Ehrenkranz

A regularity statistic for medical data analysis
J Clin Monit, 7 (1991), pp. 335-345
View in Scopus Google Scholar

22. SM Pincus, RR V'iscarello

Approximate entropy: a regularity statistic for fetal heart rate analysis
Obst Gynccol, 79 (1992), pp. 249-255
View in Scopus Google Scholar

23. SM Pincus, DI Keefe

Quantification of hormone pulsatility via approximate entropy algerithm
Am J Physiol, 262 (1992), pp. E741-E754
View article CrossRef View in Scopus Google Scholar

24. DT Keplan, MI Furman, SM Pincus, SM Ryan, LA Lipsitz, AL Goldberger

Aging and the complexity or cardiovascular dynamics
Biophys J, 59 (1991), pp. 945-949
Google Scholar

25. SM Pincus, AL Goldberger

Physiological time-series analysis: what does regularity quantify?
Am J Physiol, 266 (1994), pp. H1643-H1656
 (Heart Circ Physiol 35)
View PDF CrossRef View in Scopus Google Scholar

26. LA Lipsitz, AL Goldberger

Loss of “complexity” and aging: potential applications of fractals and chaos theory to
senescence
JAMA, 267 (1992), pp. 1806-1809
View article CrossRef View in Scopus Google Scholar

27. KEF Sands, ML Appel, LS Lilly, FJ Schoen, GH Mudge, RJ Cohen

Power spectrum analysis of heart rate variability in human cardiac transplant recipients
Circulation, 79 (1989), pp. 76-82
View in Scopus Google Scholar

28. BW Hyndman, RI Kitney, B McA Sayers

Spontaneous rhythms in physiological control systems
Nature, 233 (1971), pp. 339-341
View article CrossRef View in Scopus Google Scholar

29. B Pomeranz, RJB Macaulay, MA Caudill, et al.

Assessment of autonomic function in humans by heart rate spectral analysis
Am J Physiol, 248 (1985), pp. H151-H153
(Heart Circ Physiol 17)
View PDF View in Scopus Google Scholar

30. GE Billman, JP Dujardin

Dynamic changes in cardia, vagal tone as measured by time-scries analysis
Am J Physiol, 258 (1990), pp. H896-H902
View article CrossRef View in Scopus Google Scholar

31. J Hayano, A Yamada, S Mukai, et al.

Severity of coronary atherosclerosis correiates with the respiratory component of heart
rate variability
Am heart J, 121 (1991), pp. 1070-1079
View PDF View article View in Scopus Google Scholar

32. SJ Piha
Cardiovascular autonomic reflex tests: normal responses and age-related reference values
Clin Physiol, 11 (1991), pp. 277-290
View in Scopus Google Scholar

33. AL Goldberger
Is the normal heartbeat chaotic or homeostatic?
News in Physiological Science (Am Physiol Soc), 6 (1991), pp. 87-91
View PDF CrossRef View in Scopus Google Scholar
34. B Gribbin, TG Pickering, P Sleight, R Peto
Effect of age and high blood pressure on baroreflex sensitivity in man
Circ Res, 29 (1971), pp. 424-431
View in Scopus Google Scholar

35. B Pomeranz, JB Macaulay, MA Caudill, et al.

Assessment of autonomic function in humans by heart rate spectral analysis
Am J Physiol, 248 (1985), pp. H151-H153
View PDF View in Scopus Google Scholar

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 ☆ This work was supported in part by the Hebrew Rehabilitation Center for Aged Research and Training Institute, Boston,
Massachusetts; a National Institute on Aging Teaching Nursing Home Award (AG04390) and Claude Pepper Geriatric Research
and Training Center Grant (AG08812) from the U.S. Public Health Service, Bethesda, Maryland; and by awards from the
National Institute on Drug Abuse (P01-DA06316) and National Heart Lung, and Blood Institute (R01-HL-42172), National
Institutes of Health, Bethesda, Maryland; National Aeronautics and Space Administration (NAG9572), Bethesda. Maryland; and
the G. Harold and Leila Y. Mathers Charitable Foundation, Mt. Kisco, New York; and by a grant from the Colin Medical
Instruments Corporation, San Antonio, Texas.

2 Dr. Ryan is the recipient of a 1991 Brookdale National Fellowship Award, New York, New York.

1 Dr. Lipsitz is the recipient of the Irving and Edyth S. Usen and Family Chair in Geriatric Medicine at the Hebrew Rehabilitation
Center for Age J Research and Training Institute. Boston.

Copyright © 1994 Published by Elsevier Inc.

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