Reference ranges for short-term heart rate variability measures in individuals free of cardiovascular disease: The Multi-Ethnic Study of Atherosclerosis (MESA)

Background Normative values for heart rate variability (HRV) measures from 10-s electrocardiograms (ECG) have not been defined. Methods We reported borderline abnormal (<5th percentile) and abnormal (<2nd percentile) values of standard deviation of all normal-to-normal R-R intervals (SDNN) and root mean square of successive differences between normal-to-normal R-R intervals (rMSSD) from 10-s ECGs in 1175 participants (mean age = 59 ± 10; 59% female; 47% white) ≥45 years of age from the Multi-Ethnic Study of Atherosclerosis (MESA) who were free of cardiovascular disease (CVD) and CVD risk factors. We validated the prognostic significance of these measures in a subset of the MESA cohort with complete data. Results Borderline abnormal and abnormal SDNN and rMSSD varied by sex and race. Borderline abnormal and abnormal SDNN and rMSSD were associated with an increased risk of CVD and all-cause mortality. Conclusions The references ranges provided in this report will guide future research using these common HRV parameters.