Objective To examine possible seasonal changes in heart rate variability (H
RV).
Background Greater than normal mortality from cardiovascular disease (CVD)
in the winter has been reported for many countries and might be partly expl
ained by considering seasonal changes in CVD risk factors. Depression of HR
V is an independent predictor of arrhythmic complications and of cardiac de
ath, and it is also among the variables that may be affected by the season
of the year.
Methods We compared pairs of 24 h HRV data of 120 healthy men who were exam
ined once in the summer and once in the winter. Multivariate analyses were
performed for each dependent variable (HRV indexes) in separate statistical
models with age, resting heart rate, serum level of cholesterol, cigarette
smoking, body mass index, sports habits, alcohol consumption, systolic blo
od pressure, physical activity at work, years of education, consumption of
energy, and season as the independent variables.
Results Although there were no seasonal differences in mean R-R interval, a
ll indexes of HRV were found to be lower in the summer than they were durin
g winter. Differences and 95% confidence intervals were standard deviation
(SD) of coupling intervals between normal beats 12 ms, 6-17 ms; SD of 5 min
mean R-R intervals 14 ms, 8-20 ms; mean of all 5 min SD of R-R intervals 2
.0 ms, 0.6-2.5 ms; proportion of adjacent R-R intervals differing by > 50 m
s 1.5%, 0.6-2.5% and root mean square of the difference between successive
normal intervals 3.1 ms, 1.5-4 ms. Multivariate analyses showed that HRV in
the winter was less than that in the summer even after adjustment for age,
serum level of cholesterol, systolic blood pressure, and body mass index.
Conclusions HRV indexes of healthy men vary physiologically by season, with
lowest values obtained in the winter. Since low HRV is linked to pathologi
c conditions, the significance of seasonal changes for those suffering from
CVD and their possible contribution to the greater mortality rates in wint
er have to be considered. J Cardiovasc Risk 7:141-146 (C) 2000 Lippincott W
illiams & Wilkins.