Should heart rate variability be “corrected” for heart rate? Biological, quantitative, and interpretive considerations

de Geus, Eco J. C.; Gianaros, Peter J.; Brindle, Ryan C.; Jennings, J. Richard; Berntson, Gary G.

doi:10.1111/psyp.13287

Cited by 219Heart Rate Variability and Autonomic ControlNon-Invasive Vital Sign MonitoringMental Health Research Topics

Should heart rate variability be “corrected” for heart rate? Biological, quantitative, and interpretive considerations

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de Geus, Eco J. C., Gianaros, Peter J., Brindle, Ryan C., Jennings, J. Richard, Berntson, Gary G.·2019·Psychophysiology

DOI 10.1111/psyp.13287PMC PMC6378407

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Abstract

Metrics of heart period variability are widely used in the behavioral and biomedical sciences, although somewhat confusingly labeled as heart rate variability (HRV). Despite their wide use, HRV metrics are usually analyzed and interpreted without reference to prevailing levels of cardiac chronotropic state (i.e., mean heart rate or mean heart period). This isolated treatment of HRV metrics is nontrivial. All HRV metrics routinely used in the literature exhibit a known and positive relationship with the mean duration of the interval between two beats (heart period): as the heart period increases, so does its variability. This raises the question of whether HRV metrics should be “corrected” for the mean heart period (or its inverse, the heart rate). Here, we outline biological, quantitative, and interpretive issues engendered by this question. We provide arguments that HRV is neither uniformly nor simply a surrogate for heart period. We also identify knowledge gaps that remain to be satisfactorily addressed with respect to assumptions underlying existing HRV correction approaches. In doing so, we aim to stimulate further progress toward the rigorous use and disciplined interpretation of HRV. We close with provisional guidance on HRV reporting that acknowledges the complex interplay between the mean and variability of the heart period.

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Sympathetic and parasympathetic activity are not reciprocal, but interact in a loosely coupled fashion.
“It should be noted, though, that sympathetic and parasympathetic activity are not reciprocal, but interact in a loosely coupled fashion (e.g. Billman, 2013; de Geus et al., 2019).”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as de Geus et al., 2019
Physiological research shows that alterations in heart rate or heart rate variability may be steered by both SNS and PNS activity.
“however physiological research shows that alterations in heart rate or heart rate variability may be steered by both SNS and PNS activity (de Geus et al., 2019).”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as de Geus et al., 2019

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Authors: de Geus, E. J. C., Gianaros, P. J., Brindle, R. C., Jennings, J. R., & Berntson, G. G.
Affiliations: Department of Biological Psychology Vrije Universiteit Amsterdam The Netherlands
University of Pittsburgh (US)
Washington and Lee University (US)
The Ohio State University (US)
ORCID: Gianaros, Peter J.
Brindle, Ryan C.
Jennings, J. Richard
Berntson, Gary G.
Venue: Psychophysiology
Publisher: Wiley
Published: 2018-10-25
Volume: 56
Issue: 2
Pages: e13287-e13287
ISSN: 0048-5772 (ISSN-L)
1469-8986
DOI: 10.1111/psyp.13287
PMC: PMC6378407
OpenAlex: W2898315047
Cited by: 219
References: 115
Citations by year: 2026: 15 · 2025: 17 · 2024: 26 · 2023: 36 · 2022: 33 · 2021: 36 · 2020: 36 · 2019: 16 · 2018: 2
FWCI: 4.20
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
Locations: Psychophysiology (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, other-oa)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
VU Research Portal (submittedVersion, other-oa)
Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Funders: National Institutes of Health (HL089850, HL101959, F32 HL137227)
Ohio State University
John D. and Catherine T. MacArthur Foundation (P01‐AG020166, U19‐AG051426)
National Center for Advancing Translational Sciences (UL1TR001409, UL1TR001881, 1UL1RR025011)
Nederlandse Organisatie voor Wetenschappelijk Onderzoek
ZonMW
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Keywords: heart rate variability, heart period, heart rate
MeSH terms: Animals, Autonomic Nervous System, Heart Rate, Humans, Neurophysiology, Vagus Nerve

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Should heart rate variability be “corrected” for heart rate? Biological, quantitative, and interpretive considerations

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