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What Does Your HRV Actually Tell You? The 101 On This Buzzy Health Metric

Taneia Surles, MPH
Author:
October 26, 2024
Taneia Surles, MPH
By Taneia Surles, MPH
mbg Contributor
Taneia Surles is a health writer, editor, and public health professional. She holds a bachelor’s and a master’s degree in Public Health from the University of Alabama at Birmingham. She has bylines in Insider, Health, Healthline, AARP, Parents, and other publications.
Image by Marija Kovac / Stocksy
October 26, 2024
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Thanks to technology, we have smartwatches, wristbands, and other wearable devices that help us monitor our health. And one of their metrics that may be new to you is your heart rate variability, or HRV.

So, what exactly is your HRV, and what does it tell you about your health? We spoke to a cardiologist to better understand the ins and outs of heart rate variability and how to manage it.

What is heart rate variability?

HRV is a method for assessing changes in the cardiac cycle1. Simply put, HRV “refers to the time between heartbeats,” explains Bradley Serwer, MD, FACC, a board-certified interventional cardiologist and the Chief Medical Officer of CardioSolution. “While most people have a relatively regular heart rate, there is always some variability in the time between individual beats.”

As for how your heart rate variability works, the autonomic nervous system, or ANS, controls your heart rate2 and, ultimately, your HRV. The ANS comprises the sympathetic (“fight or flight”) and parasympathetic (“rest and digest”) responses.

“When the autonomic nervous system is in balance, there tends to be a higher variability in time between heartbeats,” said Serwer. “When the autonomic nervous system is out of balance either due to increased stress (physiologic or psychological), illness or autonomic dysfunction, the variability between heart rates decreases.”

Your HRV varies depending on your age and gender, so there’s no exact number to reference (it also fluctuates over time). Talk with your doctor to get a better idea of the exact range you should aim for based on your health.

What affects your HRV?

According to a 2021 review3, several factors impact your HRV, such as:

  • Age 
  • Gender
  • Circadian cycle (24-hour cycle based on your body’s internal clock)
  • Pathological conditions like inflammation and infection
  • Low levels of carbon monoxide
  • Social stress and noise
  • Alcohol consumption
  • Smoking cigarettes
  • Anxiety and depressive disorders
  • Genetics 

How to measure your HRV

“Heart rate variability can be measured using a standard electrocardiogram, ECG, or photoplethysmography (PPG) as seen on many smartwatches, smartphones, and fitness trackers,” said Serwer. Many people use an Apple Watch, Fitbit, chest strap, or other fitness tracker to monitor their HRV and overall heart health.

5 things your HRV can tell you

1.

Warning signs of heart conditions

Monitoring your HRV may detect early warning signs of cardiac problems. According to a 2019 study, a low HRV was a strong predictor of myocardial ischemia, which occurs when blood flow is partially or completely blocked due to plaque buildup.

If you have concerns about your HRV and what it means for your risk of heart disease, consult your healthcare provider.

2.

Stress levels

When you’re feeling stressed, your heart rate variability changes. Your HRV can indicate if you’re experiencing stress because of exposure to certain physiological or environmental stimuli4, as a 2018 meta-analysis and literature review reported. 

3.

ANS imbalances

Measuring your HRV is a noninvasive way to notify you of any imbalances in your autonomic nervous system. In fact, according to a 2020 study, HRV was a valid indicator of autonomic nervous system disturbance (ANSD)5 in patients with tetanus.

In addition, HRV may also detect mental conditions such as depression. A 2018 study revealed that ANSD indexed by HRV6 is often connected to indicators of depression. 

4.

How certain habits affect you

Knowing your HRV can help you understand your health status. You’ll be more aware of whether certain lifestyle habits improve or worsen your heart health. In addition, monitoring your HRV can motivate you to adopt healthier lifestyle habits.

5.

Emotional well-being 

A high HRV is associated with higher emotional well-being7, meaning there’s improved emotional regulation, according to a 2019 manuscript. Good emotional well-being involves handling stressful situations and adjusting to new changes7.

Ways to manage your HRV daily

Use fitness trackers to your advantage: As mentioned, an easy way to monitor your HRV is with a fitness tracker like an Apple Watch or a Fitbit, which can give users a daily fitness score. “This fitness score can be positively affected by regular aerobic exercise, lack of stress, healthy diet and may be negatively affected by sedentary lifestyles, high-stress levels or illness,” said Serwer.

Prioritize mental health: Given that stress contributes to a low HRV, ensuring you’re taking care of your mental health is essential. Some ways to incorporate self-care into your routine are engaging in mindfulness practices, talking to loved ones, taking supplements for stress, and seeking therapy if needed.

Get enough sleep: Ensure you catch enough Zzzs for your HRV. A 2020 study suggested poor sleep quality can affect your HRV8, heart rate, and blood pressure. The Centers for Disease Control and Prevention (CDC) recommends adults ages 18 to 60 get seven or more hours of sleep.

The takeaway

Your heart rate variability provides a snapshot of how your nervous system is functioning—and if your HRV is low, it could be a sign that you need to spend more time prioritizing sleep, stress management, and other factors like exercise and diet.

Your HRV is always in flux, so it's never too late to make a change for the better.

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