Heart rate and heart rate variability in panic, social anxiety, obsessive–compulsive, and generalized anxiety disorders at baseline and in response to relaxation and hyperventilation

It remains unclear if diminished high frequency heart rate variability (HF-HRV) can be found across anxiety disorders. HF-HRV and heart rate (HR) were examined in panic (PD), generalized anxiety (GAD), social anxiety (SAD), and obsessive–compulsive disorder (OCD) relative to healthy controls at baseline and during anxiety stressors. All disorders evidenced diminished baseline HF-HRV relative to controls. Baseline HRV differences were maintained throughout relaxation. For hyperventilation, PD and GAD demonstrated greater HR than controls. Psychotropic medication did not account for HF-HRV differences except in OCD. Age and sex evidenced multiple main effects. Findings suggest that low baseline HF-HRV represents a common index for inhibitory deficits across PD, GAD, and SAD, which is consistent with the notion of autonomic inflexibility in anxiety disorders. Elevated HR responses to hyperventilation, however, are specific to PD and GAD.

► Patients with panic, obsessive–compulsive, generalized, and social anxiety disorder.
► Heart rate (HR) and HR variability (HRV) at rest, hyperventilation, and relaxation.
► Lower HRV in all four anxiety disorders at rest compared to healthy controls.
► Lower HRV maintained, but not increased during relaxation.
► Elevated HR to hyperventilation only in panic and generalized anxiety patients.