Optimal HRV values blog
What Is My Optimal HRV?
A Deep Dive Into the Variables that Affect HRV and Setting Personal Goals
You may be wondering what values you should be aiming for when measuring your HRV. This is a really common question with a complicated answer. There are several variables that affect heart rate variability (or HRV for short). Age, gender, physical fitness level, certain health conditions and medications are just some of the variables that can have an effect. We will go through each of these variables and their potential effects on HRV, and also look at some general trends in HRV norms. While it is helpful to be aware of all of these factors that can influence HRV, it is best to work to improve your personal HRV rather than comparing your HRV to others.
OVERALL HRV NORM TABLES: WE ARE USING RMSSD VALUE FOR HRV:
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GENERAL: not broken down into age/gender: Nunan et al 2010 short term HRV
Nunan et al. - 2010 - A Quantitative Systematic Review of Normal Values .pdf
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Elite HRV uses this table: 1st graph on page
2. BROKEN DOWN AGE AND GENDER: Voss et al 2015 short term HRV:
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Table 7 for Males 5 different age groups and Table 5 for Females 5 different age groups:
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https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0118308&type=printable
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Elite uses this table, extracting male and female with age into 1 chart: 3rd graph down:
https://elitehrv.com/hrv-demographics-age-gender
Let’s Start by Looking at Age: The Effects of Age on HRV:
HRV is known to decrease with age in both men and women. Various studies have examined whether the age-related decline in HRV is a natural occurrence of aging or if it is due to health conditions or medication use that can occur with increasing age. A large population based study published in 2016 looked at HRV measures at three points in time over a ten year period in over four thousand people. This study found that HRV decreases with age independent of health conditions or medication use. This would suggest that decreases in HRV are due to normal aging.
Another way to think about this is that there is a normal decline in parasympathetic activity with age. Remember, the parasympathetic branch of the nervous system is the “rest and digest” branch. With age, there is less parasympathetic activity, which contributes to a lower HRV as we age.
Overall, while other variables like fitness level, health conditions, and medications that we will discuss further can affect HRV as we get older, there is also just a normal decline in HRV that occurs as we age.
The good news is that even with this age-related decline in HRV, it is still possible to continue to train our autonomic nervous system as we get older and improve our nervous system function and stress response regardless of our age.
The Effects of Gender:
In addition to the effects of age, there are also gender differences in HRV, with different studies showing conflicting effects of gender. While some studies show females have an overall higher HRV compared to males, other studies show the opposite. What the studies generally agree upon is that the difference in HRV based on gender disappears with age. This means that when we look at groups above the age of 50, we no longer find that gender has an effect on HRV. Let’s take a look at a few of the studies examining the effects of gender.
A 2015 study looked at gender differences in HRV from a group of 782 females and 1124 males. They observed gender differences with higher HRV values in females when looking at specific measures compared to males. It was hypothesized that females have a more parasympathetic predominance in younger age groups compared to men, thus leading to a higher HRV.
However, in this same 2015 study, the effect of gender disappeared for the most part after 55 years of age. It was thought that the gender effect disappears with age because of the effects of menopause and hormonal influences on the parasympathetic/sympathetic balance of the nervous system.
Another study showed the opposite conclusion. A smaller study conducted in 1994 looking at over a hundred healthy volunteers showed HRV was significantly lower in healthy females compared to healthy males in certain HRV measures. While the exact mechanisms of gender differences in HRV are not clear, one theory is that physical fitness levels in males vs females at younger ages may contribute to the higher HRV found in males in these younger age groups. This study also showed that the gender influences on HRV disappear by age 50.
So, overall, while gender has some influence on HRV particularly at younger ages, this effect of gender is no longer present after age 50 or so. Overall, age has a greater influence on HRV compared to gender.
Moving on from Age and Gender: The Effects of Fitness Levels on HRV:
Increasing physical fitness levels in general can certainly have a positive effect on multiple health outcomes and measures including HRV. The good news is that studies have shown light to moderate aerobic exercise can have a positive effect, improving autonomic nervous system balance and increasing HRV. This effect has been shown across the spectrum of age groups from teens to the elderly. Other studies have shown that in addition to the benefits of aerobic exercise, strength training can have similar positive effects on HRV and the nervous system.
A recent meta-analysis published in 2021 looked at the effects of different types of fitness and exercise training on HRV. They looked at 12 studies overall, focusing on young and middle aged adults. The studies included a variety of exercise modalities including endurance/aerobic training, strength training, or some combination. Overall, they found that all types of exercise interventions had a positive effect on autonomic function and improved HRV.
Another study looked at participants in a broader age range. They evaluated 72 male runners aged 15-83 years old and compared them to age and weight matched sedentary controls. Overall, they found that the physically active group had a higher fitness level and higher HRV compared to the sedentary group. This study showed that aerobic exercise can help to improve HRV in a wide age range.
Overall, increasing fitness through various forms of exercise from aerobic activity to strength training or some combination of these modalities, can have a significant impact in improving health, autonomic nervous system balance, and HRV.
Some Caveats when looking at High/Low HRV in relation to fitness levels:
There are some caveats when looking at overall HRV trends and fitness levels. We cannot always assume higher HRV is good and lower HRV is bad. When looking at higher HRV, some studies have shown an increase in HRV being associated with overtraining in endurance athletes. In this case, a higher HRV is not a good thing, as it was actually associated with decreased exercise performance from overtraining.
Along the same lines, when looking at lower HRV, this is not always a bad sign. Lower HRV can sometimes be observed in athletes before a competition simply because of anxiety/excitement. A lower HRV score can also be associated with higher intensity training in athletes; and this is not necessarily associated with lower performance.
So, these are just some reminders that various factors can affect the interpretation of HRV, and while in general healthy levels of exercise in various forms can improve HRV, it is important to keep in mind that factors like over-training can have negative health effects, and short-term dips in HRV can sometimes just be from the temporary effects of anxiety/excitement.
The Effects of Health Conditions on HRV:
Lower HRV can be associated with various health conditions. Mental health conditions such as depression, anxiety and PTSD, as well as physical conditions such as chronic pain, asthma, diabetes and cardiovascular disease, can all be associated with an increase in sympathetic predominance in the nervous system. Remember that the sympathetic arm has to do with the “flight or fight” branch of the nervous system. With this increase in sympathetic predominance, these conditions can all be associated with a lower HRV.
Mental Health Conditions and HRV:
When looking at the relationship between HRV and major depression, a 2019 meta-analysis examining over four thousand patients showed significant differences in HRV between those with major depression compared to healthy controls. Another 2014 meta-analysis had similar findings when looking at the relationship between HRV and anxiety. These studies overall found that both depression and anxiety are related to lower HRV.
Metabolic Conditions and HRV:
In addition to mental health conditions, various metabolic conditions have also been associated with lower HRV. One study found patients with diabetes, as well as those with elevated serum glucose or insulin without a diagnosis of diabetes, all had lower vagal activity and lower HRV. This shows an association between blood sugar imbalances and lower HRV.
A review paper published in 2008 looked at data from 13 studies on the relationship between inflammatory markers and HRV. They found that those subjects with high inflammatory markers had lower HRV; this was found to be true in those with cardiovascular disease as well as in healthy individuals. This study demonstrated that anyone with elevated inflammatory markers, regardless of whether or not they have a diagnosed condition, had lower HRV.
One caveat to keep in mind when thinking about cardiac disease and HRV: just as we discussed in the fitness/exercise section, we have to be careful and not assume that higher HRV is always a good thing. There are cases where serious conditions such as cardiac conduction abnormalities result in a higher HRV, so just keep in mind that it’s not always black and white as far as lower HRV being bad and higher HRV being good.
Meds:
Certain medications can also affect HRV. For example, mental health medications such as tricyclic antidepressants and SSRIs, can have effects on HRV.
Conclusions:
When measuring HRV on an individual level, it’s important to aim for improving your personal HRV rather than comparing yourself to other groups. There are so many factors that can affect HRV, that personal growth is really the goal. It’s also important to keep in mind that there is a somewhat set limit on how much improvement any one individual can achieve, and then it’s important to maintain that improvement rather than expecting to have a continued increase in HRV indefinitely. If you’ve been using HRV biofeedback for several weeks to months and have hit a plateau, this may be because you have reached your optimal HRV. At that point, think of your HRV biofeedback practice as a way to maintain your improvement just like with exercise. Ongoing practice is needed to sustain the improvement.
Extra notes:
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HRV Norm table for 20s-40s only in “Age and Sex dependent alterations in HRV” article.
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tables from Nunan et al. for general HRV parameters and Umetani et al. 1998 for age specific but Umetani is 24 hour not short term.
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Voss et al. for gender differences in HRV with F > M for age ranges; but gender related variation goes down above 55 yo
Podcasts:
References:
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https://www.vitalscan.com/dt_factors_affect_stress.htm
LE MEUR, YANN1; PICHON, AURÉLIEN2; SCHAAL, KARINE1,3; SCHMITT, LAURENT4; LOUIS, JULIEN1; GUENERON, JACQUES5; VIDAL, PIERRE PAUL6; HAUSSWIRTH, CHRISTOPHE1 Evidence of Parasympathetic Hyperactivity in Functionally Overreached Athletes, Medicine & Science in Sports & Exercise: November 2013 - Volume 45 - Issue 11 - p 2061-2071 doi: 10.1249/MSS.0b013e3182980125
