MODULATION OF HEART RATE VARIABILITY PARAMETERS IN WOMEN OF OLDER AGE GROUPS
Keywords:
heart rate variability, autonomic nervous system, electrocardiography, LF, HF, LF/HF, Amo%, women, hormonal changes, postmenopause, middle age, old age, aging, cardiovascular risk, adaptationAbstract
The article presents the results of a study on the modulation of heart rate variability (HRV) parameters in middle-aged and older women. A total of 57 conditionally healthy women aged 44–80 years participated, divided according to the WHO classification into two groups: 44–60 years (n=21, mean age 47.62 ± 2.13 years) and 61–80 years (n=36, mean age 66.13 ± 5.02 years). Twenty-four-hour ambulatory Holter ECG monitoring was conducted at the "MED-SOYUZ" Medical Center LLC (Sumy, Ukraine) using the "CardioSens CS" system (KhAI-MEDIKA LLC, Kharkiv, Ukraine). Temporal HRV parameters, such as the mean RR interval (mRR: 858.50 (750.37; 957.79) ms in the middle-aged group during daytime vs. 813.05 (683.36; 893.81) ms in the elderly group), SDNNi (80.28 (76.17; 145.18) ms vs. 61.07 (47.31; 104.56) ms), and RMSSD (118.79 (84.85; 195.87) ms vs. 117.13 (63.59; 127.94) ms), as well as spectral parameters (LF, HF, LF/HF, and Amo%), were analyzed. Data were processed by dividing into daytime (08:00–22:00) and nighttime (22:00– 08:00) periods. Statistical analysis included the Shapiro-Wilk test for normality (non-normal distribution, p < 0.05) and the Mann- Whitney U-test for group comparisons (p < 0.05). Results revealed a significant reduction in LF (1453.59 (266.57; 3427.03) ms² vs. 748.24 (589.76; 2381.27) ms², p < 0.05) and HF (1291.27 (565.96; 5034.61) ms² vs. 1452.58 (895.42; 2944.44) ms², p < 0.05) in the elderly group, indicating a decrease in overall variability and parasympathetic activity with age. Conversely, Amo% significantly increased (38.57 (35.90; 41.84)% vs. 68.46 (66.42; 70.59)%, p < 0.001), suggesting enhanced autonomic regulation, likely due to postmenopausal estrogen deficiency affecting autonomic balance. The LF/HF ratio remained stable (0.70 (0.51; 0.90) vs. 0.70 (0.60; 0.80), p > 0.05), demonstrating preserved sympatho-parasympathetic balance for the daytime period, and no significant differences were found for the nighttime period after removing outliers (0.49 (0.21; 0.57) vs. 0.57 (0.23; 0.80), p > 0.05). Nighttime changes showed an increase in HF (6363.06 (3908.87; 11896.74) ms² vs. 887.14 (425.23; 5580.90) ms²) and a decrease in LF/HF (0.49 (0.21; 0.57) vs. 0.57 (0.23; 0.80), p < 0.05), although lower HF values in older women highlight diminished parasympathetic reserves.The findings underscore the significant impact of aging and hormonal changes on HRV, as well as the potential role of Amo% as a marker of cardiovascular risk, necessitating further research to develop preventive strategies for older women.
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