Journal article
Guidelines for rigor and reproducibility of heart rate variability within human cardiovascular research
American journal of physiology. Heart and circulatory physiology
07/24/2026
DOI: 10.1152/ajpheart.00041.2026
PMID: 42495990
Abstract
Heart rate variability (HRV) is a widely utilized approach for investigating cardiovascular health and human performance. Methodological approaches, analyses, and interpretations of HRV can vary extensively, and scientific debates on HRV reliability and utility remain. These debates have been amplified in recent years by the rapid growth and ubiquity of wearable devices, and their incorporation into scientific research studies. The present guidelines paper takes an evidence-based approach to propose more consistent and rigorous measurement and interpretation of HRV within human cardiovascular research and application. First, HRV has some utility as a cardiovascular risk stratification tool, but is not appropriate to employ as a specific marker of cardiac sympathetic outflow or sympathovagal balance. While time-domain and spectral analysis can more accurately reflect respiratory modulation of cardiac vagal (parasympathetic) activity, caution is necessary to avoid overinterpretation, particularly with respect to the concept of "vagal tone". Numerous experimental, demographic, and environmental factors influence HRV assessment, interpretation, and reliability. Specifically, it is critical to account for non-modifiable (age, sex, race/ethnicity, etc.) and modifiable (i.e., exercise, physical fitness, etc.) factors within participant samples. Furthermore, technical approaches such as the HRV input signal (e.g., electrocardiography vs. photoplethysmography), length of recording, location of recordings (i.e., laboratory vs. field), respiratory rate and depth, and analytical approaches (i.e., time vs. frequency domain) can all impact rigor, reliability, and study interpretations. Finally, with respect to the rapid advancements of HRV assessment using wearable technology, investigators should interpret and contextualize findings within the limitations outlined in this guideline review.
Details
- Title: Subtitle
- Guidelines for rigor and reproducibility of heart rate variability within human cardiovascular research
- Creators
- Jason R Carter - Baylor UniversityNathaniel D M Jenkins - University of Wisconsin–MadisonJeremy A Bigalke - Baylor UniversityAustin T Robinson - Indiana UniversityManda L Keller-Ross - University of Minnesota SystemJody L Greaney - University of DelawareIda T Fonkoue - University of Minnesota SystemPaul J Fadel - The University of Texas at ArlingtonVaughan G Macefield - Australian Regenerative Medicine InstituteNisha Charkoudian - U.S. Army Research Institute of Environmental MedicineBenjamin D Levine - The University of Texas Southwestern Medical CenterMichael J Joyner - Mayo Clinic in Arizona
- Resource Type
- Journal article
- Publication Details
- American journal of physiology. Heart and circulatory physiology
- DOI
- 10.1152/ajpheart.00041.2026
- PMID
- 42495990
- NLM abbreviation
- Am J Physiol Heart Circ Physiol
- ISSN
- 1522-1539
- eISSN
- 1522-1539
- Publisher
- American Physiological Society
- Grant note
- 2L30HL149066 / HHS | National Institutes of Health (NIH) 1R01HL167788 / HHS | National Institutes of Health (NIH) 24TPA1290435 / American Heart Association (AHA) 2019404 / DHAC | National Health and Medical Research Council (NHMRC)
- Language
- English
- Electronic publication date
- 07/24/2026
- Academic Unit
- Psychological and Brain Sciences; Injury Prevention Research Center; Health, Sport, and Human Physiology
- Record Identifier
- 9985183640102771
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