Decreased HRV - Should You be Worried?

HRV is a non-invasive and simple-to-measure biomarker that measures the time difference between successive heartbeats that can indicate the state of the autonomic nervous system (ANS). Maintaining physiological balance and regulating stress levels require a healthy ANS. Reduced HRV is a sign of ANS dysfunction and has been linked to a variety of health problems such as cardiovascular disease, diabetes, and depression. In this article, we will look at what decreased HRV means, what factors can cause it, and how to improve it.

Factors That Influence HRV

A variety of factors influence HRV, including age, stress, physical activity, and medical conditions. Understanding these factors and their effects on HRV can help people improve their health and reduce their risk of developing chronic diseases. HRV can be influenced by a variety of factors, including:

  • Age
  • Stress
  • Sleep
  • Physical activity
  • Nutrition
  • Caffeine and alcohol consumption
  • Medical conditions
  • Medications

Causes Of Decreased HRV

Reduced HRV can be caused by several factors like lifestyle choices, medical conditions, and medications. Chronic stress, poor sleep quality, physical inactivity, and a high-processed food-and-sugar diet can all contribute to a low HRV. Lower HRV is linked to medical conditions such as diabetes, cardiovascular disease, and depression. As a side effect, certain medications, such as beta-blockers and some antidepressants, can reduce HRV. Age and gender can play a role, with HRV decreasing with age and being lower in women than men. 

Cardiovascular Disease

Research has shown that reduced HRV is linked to an increased risk of cardiovascular disease.  A low HRV indicates a malfunctioning autonomic nervous system, which can increase the risk of hypertension, atherosclerosis, and other cardiovascular problems. Reduced HRV has also been linked to an increased risk of heart attack, stroke, and sudden cardiac death. According to research, people with low HRV are up to four times more likely than those with high HRV to develop cardiovascular disease. 


Decreased HRV has been linked to an increased risk of type 2 diabetes. Research has shown that individuals with lower HRV are more likely to develop insulin resistance, a condition in which the body's cells become less responsive to insulin, resulting in high blood sugar levels. Insulin resistance is a major contributor to the development of type 2 diabetes, as well as an increased risk of cardiovascular disease. The link between decreased HRV and diabetes is thought to be due in part to the effects of chronic stress on the autonomic nervous system. 

Chronic Stress

Research has shown that chronic stress is linked to lower HRV, which can harm physical and mental health.

The balance between the sympathetic nervous system (SNS), which activates the body's "fight or flight" response, and the parasympathetic nervous system (PNS), which activates the body's "rest and digest" response, plays an important role in determining HRV. Chronic stress can result in an overactive SNS, which raises heart rate and lowers HRV. 


Some medications have been shown to reduce HRV. Beta-blockers, for example, are a type of medication that is commonly used to treat high blood pressure, angina, and heart failure. Beta-blockers work by slowing the heart rate and decreasing the force of the heart contractions, which can result in a decrease in HRV. Antidepressants (TCAs) have been linked to decreased HRV. TCAs work by preventing the re-uptake of certain neurotransmitters in the brain, which can reduce HRV.

Some medications, on the other hand, have been shown to increase HRV. Angiotensin-converting enzyme (ACE) inhibitors, which are used to treat hypertension and heart failure, have been shown to improve HRV. This could be because ACE inhibitors help to reduce inflammation and improve blood vessel function.

It's important to note that the effect of medication on HRV varies depending on the individual and the medication in question. Medication may be required to treat a health condition in some cases, even if it reduces HRV. 

Sleep Disorders

Sleep disorders like obstructive sleep apnea (OSA) and insomnia have been linked to lower HRV. OSA is a condition in which a person's breathing during sleep is interrupted. This pause in breathing activates the sympathetic nervous system (SNS), resulting in an increase in heart rate and a decrease in HRV. This can lead to chronic sympathetic activation and decreased HRV, even during waking hours.

Insomnia has been linked to a reduction in parasympathetic nervous system (PNS) activity during sleep, resulting in a decrease in HRV. The PNS promotes relaxation, and a decrease in PNS activity can result in increased sympathetic activation and a decrease in HRV.

Sleep disorders can result in poor sleep quality, which can lower HRV. Poor sleep quality can result in increased sympathetic activation and decreased PNS activity, resulting in decreased HRV. 

Other Medical Conditions

Reduced HRV has been associated with several other medical conditions, including:

  • Obesity
  • Chronic obstructive pulmonary disease (COPD)
  • Depression and anxiety

While decreased HRV is a risk factor for these conditions, it is not necessarily a causative factor and more research is needed to fully understand the relationship between HRV and these medical conditions.

Symptoms Of Decreased HRV

HRV does not always cause symptoms. However, in some cases, low HRV can result in symptoms. It is important to note that these symptoms are not limited to low HRV and can be caused by a variety of medical conditions. 

Fatigue And Low Energy

Low HRV may cause feelings of fatigue or exhaustion because the body is unable to regulate heart rate and other bodily functions.

Dizziness And Lightheadedness

Low HRV can cause changes in blood pressure or blood flow, resulting in dizziness or lightheadedness.

Shortness Of Breath

Shortness of breath may be a symptom of a cardiovascular condition such as heart failure.

Chest Pain Or Discomfort

Chest pain or discomfort may be a symptom of a cardiovascular condition such as coronary artery disease.

Irregular Heartbeat

HRV and irregular heartbeat (arrhythmia) are separate but often related conditions. While decreased HRV may indicate an underlying condition, it does not always result in an irregular heartbeat. However, conditions that cause decreased HRV, can increase the risk of developing arrhythmias like atrial fibrillation, ventricular tachycardia, and bradyarrhythmias. Some studies suggest that low HRV is linked to an increased risk of sudden cardiac death, often caused by arrhythmias.

The Implications Of Decreased HRV

Reduced heart rate variability (HRV) can have consequences for an individual's health. Reduced HRV has been linked to an increased risk of medical conditions, particularly those related to cardiovascular risk. Decreased HRV has also been linked to an increased risk of mortality, particularly in people who already have cardiovascular disease. 

Reduced HRV indicates an increased risk of anxiety, depression, and other mental health conditions, in addition to its physical health implications.

How To Measure And Track HRV

There are various methods for measuring and tracking HRV. Electrocardiography (ECG or EKG), which measures electrical signals produced by the heart, is one of the most commonly used methods. This technology is used in clinical settings and can provide a detailed analysis of HRV. There are affordable and convenient options for personal use, like wearable devices that monitor HRV via heart rate sensors. 

These devices monitor HRV over time and provide information about the impact of factors on HRV. There are also smartphone apps that measure HRV using photoplethysmography (PPG) sensors, which detect changes in blood flow through the skin. To capture data, these apps require the user to place their finger over the smartphone camera lens and flash.

Treatment And Prevention Of Decreased HRV

The treatment and prevention of low HRV are dependent on the underlying cause. Lifestyle changes like increasing physical activity, improving diet, and reducing stress, as well as medications, can help. It is beneficial to avoid smoking and excessive alcohol consumption. Regular medical check-ups and addressing underlying conditions or risk factors can reduce the risk of associated health consequences.

The Importance Of Managing HRV For Improved Health

Reduced heart rate variability (HRV) can have serious consequences for one's health, including an increased risk of cardiovascular disease, mortality, and mental health problems. HRV can often be improved with appropriate treatment and lifestyle changes. Regular medical check-ups, as well as addressing underlying conditions or risk factors, are critical for managing low HRV and avoiding the associated health consequences. Individuals can improve their health and reduce their risk of developing serious health conditions by taking steps to improve HRV.