Heart rate variability in patients with anxiety disorders: A systematic review and meta‐analysis

Aims Patients with anxiety disorders (AD) have been found to have lower heart rate variability (HRV) than healthy individuals in some studies, but this was inconsistent. Furthermore, the influence of distinct diagnoses, study design, and demographic factors on the results was not comprehensively exa...

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Vydané v:	Psychiatry and clinical neurosciences Ročník 76; číslo 7; s. 292 - 302
Hlavní autori:	Cheng, Ying‐Chih, Su, Min‐I, Liu, Cheng‐Wei, Huang, Yu‐Chen, Huang, Wei‐Lieh
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Melbourne John Wiley & Sons Australia, Ltd 01.07.2022 Wiley Subscription Services, Inc
Predmet:	Anxiety Anxiety disorders Anxiety Disorders - psychology generalized anxiety disorder Heart rate Heart Rate - physiology Humans Meta-analysis Panic Disorder parasympathetic activity Parasympathetic nervous system post‐traumatic stress disorder Stress Disorders, Post-Traumatic Systematic review vagal activity post-traumatic stress disorder anxiety disorders generalized anxiety disorder parasympathetic activity vagal activity
ISSN:	1323-1316, 1440-1819, 1440-1819
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Abstract	Aims Patients with anxiety disorders (AD) have been found to have lower heart rate variability (HRV) than healthy individuals in some studies, but this was inconsistent. Furthermore, the influence of distinct diagnoses, study design, and demographic factors on the results was not comprehensively examined. Methods We gathered studies comparing HRV in patients with AD and in healthy controls. The parasympathetic activity in the hierarchical order principle was adopted in the main analysis. We adopted the random effects model to calculate the standardized mean difference. Results Of the 7805 screened studies, 99 were included in the quantitative analysis, with a total of 4897 AD patients and 5559 controls finally entered the meta‐analysis. AD patients had a significantly lower resting‐state HRV for parasympathetic activity compared to control (Hedges' g = −0.3897). For the diagnostic subgroup analysis relative to the controls, resting‐state HRV was significantly lower in post‐traumatic stress disorder, panic disorder, generalized anxiety disorder, and social anxiety disorder patients. HRV reactivity (all reactivity data, data on physiological challenge, and psychological challenge) did not show significant inter‐group differences between AD patients and healthy subjects. Conclusions The results supported that patients with AD had significantly lower resting‐state HRV than the healthy population, but no alterations were found for HRV reactivity.
AbstractList	Patients with anxiety disorders (AD) have been found to have lower heart rate variability (HRV) than healthy individuals in some studies, but this was inconsistent. Furthermore, the influence of distinct diagnoses, study design, and demographic factors on the results was not comprehensively examined.AIMSPatients with anxiety disorders (AD) have been found to have lower heart rate variability (HRV) than healthy individuals in some studies, but this was inconsistent. Furthermore, the influence of distinct diagnoses, study design, and demographic factors on the results was not comprehensively examined.We gathered studies comparing HRV in patients with AD and in healthy controls. The parasympathetic activity in the hierarchical order principle was adopted in the main analysis. We adopted the random effects model to calculate the standardized mean difference.METHODSWe gathered studies comparing HRV in patients with AD and in healthy controls. The parasympathetic activity in the hierarchical order principle was adopted in the main analysis. We adopted the random effects model to calculate the standardized mean difference.Of the 7805 screened studies, 99 were included in the quantitative analysis, with a total of 4897 AD patients and 5559 controls finally entered the meta-analysis. AD patients had a significantly lower resting-state HRV for parasympathetic activity compared to control (Hedges' g = -0.3897). For the diagnostic subgroup analysis relative to the controls, resting-state HRV was significantly lower in post-traumatic stress disorder, panic disorder, generalized anxiety disorder, and social anxiety disorder patients. HRV reactivity (all reactivity data, data on physiological challenge, and psychological challenge) did not show significant inter-group differences between AD patients and healthy subjects.RESULTSOf the 7805 screened studies, 99 were included in the quantitative analysis, with a total of 4897 AD patients and 5559 controls finally entered the meta-analysis. AD patients had a significantly lower resting-state HRV for parasympathetic activity compared to control (Hedges' g = -0.3897). For the diagnostic subgroup analysis relative to the controls, resting-state HRV was significantly lower in post-traumatic stress disorder, panic disorder, generalized anxiety disorder, and social anxiety disorder patients. HRV reactivity (all reactivity data, data on physiological challenge, and psychological challenge) did not show significant inter-group differences between AD patients and healthy subjects.The results supported that patients with AD had significantly lower resting-state HRV than the healthy population, but no alterations were found for HRV reactivity.CONCLUSIONSThe results supported that patients with AD had significantly lower resting-state HRV than the healthy population, but no alterations were found for HRV reactivity. AimsPatients with anxiety disorders (AD) have been found to have lower heart rate variability (HRV) than healthy individuals in some studies, but this was inconsistent. Furthermore, the influence of distinct diagnoses, study design, and demographic factors on the results was not comprehensively examined.MethodsWe gathered studies comparing HRV in patients with AD and in healthy controls. The parasympathetic activity in the hierarchical order principle was adopted in the main analysis. We adopted the random effects model to calculate the standardized mean difference.ResultsOf the 7805 screened studies, 99 were included in the quantitative analysis, with a total of 4897 AD patients and 5559 controls finally entered the meta‐analysis. AD patients had a significantly lower resting‐state HRV for parasympathetic activity compared to control (Hedges' g = −0.3897). For the diagnostic subgroup analysis relative to the controls, resting‐state HRV was significantly lower in post‐traumatic stress disorder, panic disorder, generalized anxiety disorder, and social anxiety disorder patients. HRV reactivity (all reactivity data, data on physiological challenge, and psychological challenge) did not show significant inter‐group differences between AD patients and healthy subjects.ConclusionsThe results supported that patients with AD had significantly lower resting‐state HRV than the healthy population, but no alterations were found for HRV reactivity. Aims Patients with anxiety disorders (AD) have been found to have lower heart rate variability (HRV) than healthy individuals in some studies, but this was inconsistent. Furthermore, the influence of distinct diagnoses, study design, and demographic factors on the results was not comprehensively examined. Methods We gathered studies comparing HRV in patients with AD and in healthy controls. The parasympathetic activity in the hierarchical order principle was adopted in the main analysis. We adopted the random effects model to calculate the standardized mean difference. Results Of the 7805 screened studies, 99 were included in the quantitative analysis, with a total of 4897 AD patients and 5559 controls finally entered the meta‐analysis. AD patients had a significantly lower resting‐state HRV for parasympathetic activity compared to control (Hedges' g = −0.3897). For the diagnostic subgroup analysis relative to the controls, resting‐state HRV was significantly lower in post‐traumatic stress disorder, panic disorder, generalized anxiety disorder, and social anxiety disorder patients. HRV reactivity (all reactivity data, data on physiological challenge, and psychological challenge) did not show significant inter‐group differences between AD patients and healthy subjects. Conclusions The results supported that patients with AD had significantly lower resting‐state HRV than the healthy population, but no alterations were found for HRV reactivity. Patients with anxiety disorders (AD) have been found to have lower heart rate variability (HRV) than healthy individuals in some studies, but this was inconsistent. Furthermore, the influence of distinct diagnoses, study design, and demographic factors on the results was not comprehensively examined. We gathered studies comparing HRV in patients with AD and in healthy controls. The parasympathetic activity in the hierarchical order principle was adopted in the main analysis. We adopted the random effects model to calculate the standardized mean difference. Of the 7805 screened studies, 99 were included in the quantitative analysis, with a total of 4897 AD patients and 5559 controls finally entered the meta-analysis. AD patients had a significantly lower resting-state HRV for parasympathetic activity compared to control (Hedges' g = -0.3897). For the diagnostic subgroup analysis relative to the controls, resting-state HRV was significantly lower in post-traumatic stress disorder, panic disorder, generalized anxiety disorder, and social anxiety disorder patients. HRV reactivity (all reactivity data, data on physiological challenge, and psychological challenge) did not show significant inter-group differences between AD patients and healthy subjects. The results supported that patients with AD had significantly lower resting-state HRV than the healthy population, but no alterations were found for HRV reactivity.
Author	Liu, Cheng‐Wei Cheng, Ying‐Chih Huang, Wei‐Lieh Su, Min‐I Huang, Yu‐Chen
Author_xml	– sequence: 1 givenname: Ying‐Chih orcidid: 0000-0002-5329-1249 surname: Cheng fullname: Cheng, Ying‐Chih organization: Taipei Medical University – sequence: 2 givenname: Min‐I surname: Su fullname: Su, Min‐I organization: Department of Medicine, MacKay Medical College – sequence: 3 givenname: Cheng‐Wei surname: Liu fullname: Liu, Cheng‐Wei organization: National Taiwan University – sequence: 4 givenname: Yu‐Chen surname: Huang fullname: Huang, Yu‐Chen organization: Taipei Medical University – sequence: 5 givenname: Wei‐Lieh orcidid: 0000-0001-5786-3366 surname: Huang fullname: Huang, Wei‐Lieh email: y03046@ms1.ylh.gov.tw, weiliehhuang@gmail.com organization: National Taiwan University Hospital Yunlin Branch
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Keywords	post-traumatic stress disorder anxiety disorders generalized anxiety disorder parasympathetic activity vagal activity
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Snippet	Aims Patients with anxiety disorders (AD) have been found to have lower heart rate variability (HRV) than healthy individuals in some studies, but this was... Patients with anxiety disorders (AD) have been found to have lower heart rate variability (HRV) than healthy individuals in some studies, but this was... AimsPatients with anxiety disorders (AD) have been found to have lower heart rate variability (HRV) than healthy individuals in some studies, but this was...
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SubjectTerms	Anxiety Anxiety disorders Anxiety Disorders - psychology generalized anxiety disorder Heart rate Heart Rate - physiology Humans Meta-analysis Panic Disorder parasympathetic activity Parasympathetic nervous system post‐traumatic stress disorder Stress Disorders, Post-Traumatic Systematic review vagal activity
Title	Heart rate variability in patients with anxiety disorders: A systematic review and meta‐analysis
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