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

•We defined the normative ranges of heart rate variability (HRV) measures (SDNN and rMSSD) obtained from the 10-s ECG in a sample of participants from the Multi-Ethnic Study of Atherosclerosis (MESA) ≥45 years of age without cardiovascular disease (CVD) or CVD risk factors.•Borderline abnormal and abnormal values for SDNN and rMSSD were found to vary by sex and race.•Borderline abnormal and abnormal values for SDNN and rMSSD were significantly associated with CVD events and all-cause mortality in the entire MESA cohort.

BackgroundNormative values for heart rate variability (HRV) measures from 10-s electrocardiograms (ECG) have not been defined.MethodsWe 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.ResultsBorderline 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.ConclusionsThe references ranges provided in this report will guide future research using these common HRV parameters.