The relationship between heart rate variability and inflammatory markers in cardiovascular diseases

Psychoneuroendocrinology. 2008 Nov;33(10):1305-12. doi: 10.1016/j.psyneuen.2008.08.007. Epub 2008 Sep 25.


Introduction: Recent evidence implicates a cholinergic anti-inflammatory pathway. Because vagus nerve activity mediates some heart rate variability (HRV), this qualitative review examines the literature concerning circulating cytokines and HRV in cardiovascular function in humans. This qualitative review examines the literature concerning circulating cytokines and HRV in cardiovascular function in humans.

Methods: Thirteen studies on HRV, inflammation, and cardiovascular function were located by electronic library search and descriptively reviewed.

Results: The relationship between HRV and inflammation was studied in healthy controls, patients with acute or stable coronary heart disease (CHD), patients with metabolic syndrome or impaired glucose tolerance and patients with kidney failure. Investigations focused mainly on Interleukin-6 (IL-6) and C-reactive peptide (CRP). The majority of reviewed studies reported that parasympathetic nervous system tone as inferred from heart rate variability is inversely related to inflammatory markers (r values between -0.2 and -0.4). The relationships with inflammatory markers were similar whether derived from ECG signals as short as 5-30min or from 24-h ECG readings for HRV analyses. While inflammatory markers appear to be related to HRV, it is a mistake to assume that the traditional "vagal measures" of HRV (such as high frequency heart rate variability) are the driving factors. Indeed, low frequency heart rate variability, a complex measure reflecting both parasympathetic and sympathetic activity, is the more commonly associated measure linked to inflammatory markers.

Discussion: Heart rate variability is inversely correlated with inflammatory markers in healthy individuals as well as in those with cardiovascular diseases.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Biomarkers / metabolism*
  • Cardiovascular Diseases / metabolism*
  • Cardiovascular Diseases / physiopathology*
  • Coronary Disease / metabolism
  • Coronary Disease / physiopathology
  • Glucose Intolerance / metabolism
  • Glucose Intolerance / physiopathology
  • Heart Rate / physiology*
  • Humans
  • Inflammation / metabolism*
  • Kidney Diseases / metabolism
  • Kidney Diseases / physiopathology
  • Metabolic Syndrome / metabolism
  • Metabolic Syndrome / physiopathology


  • Biomarkers