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Peer-reviewedCC BY-NCAnnals of neurosciences

Cardiovascular Autonomic Function and HRV in Healthy Adults of Rajasthan: A Cross-sectional Study on the Influence of Age and Gender.

  • Reshu Gupta1
  • Rajprabha1
  • Devendra Agarwal2
  • Geetanjali Sageena3
  • Ila Joshi4
  • Pintu Nahata5
5 affiliations
  1. 1Department of Physiology, RUHS College of Medical Sciences, Jaipur, Rajasthan, India.
  2. 2Department of Medicine, Sardar Patel Medical College, Bikaner, Rajasthan, India.
  3. 3Division of HRD, Department of Health Research, New Delhi, Delhi, India.
  4. 4Department of Physiology, Arya Medical College and Hospital, Jaipur, Rajasthan, India.
  5. 5Department of Cardiology, Sardar Patel Medical College, Bikaner, Rajasthan, India.
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Abstract

Background

Heart rate variability (HRV) and cardiovascular autonomic reflex tests (CARTs) serve as non-invasive clinical indicators of central autonomic network function and cardiovagal regulation.Purpose

This study aimed to establish regional normative reference values for HRV and CART parameters in healthy adults from northwestern India to evaluate the modulating effects of age, biological sex and subclinical cardiometabolic risk factors.Methods

This cross-sectional study evaluated 142 healthy subjects (74 males, 68 females) aged 18-70 years. Baseline vital signs and time-domain HRV parameters (standard deviation of normal-to-normal intervals (SDNN) and root mean square of successive differences (RMSSD)) were recorded. Autonomic reactivity was assessed using deep breathing (expiration-to-inspiration (E:I) ratio), the Valsalva manoeuvre, isometric handgrip and orthostatic challenge. A high-risk sub-cohort (n = 21) with subclinical obesity or elevated blood pressure was analysed. Adherence to Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines was maintained.Results

The total study sample comprised 142 participants, including 74 males (52.1%) and 68 females (47.9%). The high-risk subset comprised 11 males (52.4%) and 10 females (47.6%). Resting heart rate was higher in females (74.6 ± 8.2 bpm) than in males (70.1 ± 7.6 bpm; t(140) = 3.39, p = .02), while blood pressure was higher in males (p = .03). Time-domain HRV and reflex indices declined significantly with age (p < .001), with optimal thresholds for autonomic senescence occurring at 47 years (SDNN, area under the curve (AUC) = 0.82) and 49 years (Valsalva, AUC = 0.79). Healthy females exhibited enhanced cardiovagal responses (E:I, Valsalva and 30:15 ratios; p < .05). This female autonomic advantage was entirely blunted in the high-risk subset (n = 21), where autonomic parameters fell below the 5th percentile limits (SDNN = 25 ms, RMSSD = 18 ms, Valsalva ratio = 1.09).Conclusion

Healthy adults exhibit an age-related decline in parasympathetic function and a female-specific cardiovagal advantage. Subclinical cardiometabolic risk factors override these physiological buffers, blunting gender-related protection and accelerating autonomic senescence.

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Cite

BibTeXRIS
BibTeX
@article{gupta2026cardiovascular,
  title = {{Cardiovascular Autonomic Function and HRV in Healthy Adults of Rajasthan: A Cross-sectional Study on the Influence of Age and Gender.}},
  author = {Reshu Gupta and Rajprabha and Devendra Agarwal and Geetanjali Sageena and Ila Joshi and Pintu Nahata},
  journal = {Annals of neurosciences},
  year = {2026},
  month = oct,
  doi = {10.1177/09727531261487806},
  url = {https://europepmc.org/article/MED/42909127},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Cardiovascular Autonomic Function and HRV in Healthy Adults of Rajasthan: A Cross-sectional Study on the Influence of Age and Gender.
AU  - Reshu Gupta
AU  - Rajprabha
AU  - Devendra Agarwal
AU  - Geetanjali Sageena
AU  - Ila Joshi
AU  - Pintu Nahata
PY  - 2026
DA  - 2026/10/19
JO  - Annals of neurosciences
DO  - 10.1177/09727531261487806
UR  - https://europepmc.org/article/MED/42909127
AB  - Background  Heart rate variability (HRV) and cardiovascular autonomic reflex tests (CARTs) serve as non-invasive clinical indicators of central autonomic network function and cardiovagal regulation.Purpose  This study aimed to establish regional normative reference values for HRV and CART parameters in healthy adults from northwestern India to evaluate the modulating effects of age, biological sex and subclinical cardiometabolic risk factors.Methods  This cross-sectional study evaluated 142 healthy subjects (74 males, 68 females) aged 18-70 years. Baseline vital signs and time-domain HRV parameters (standard deviation of normal-to-normal intervals (SDNN) and root mean square of successive differences (RMSSD)) were recorded. Autonomic reactivity was assessed using deep breathing (expiration-to-inspiration (E:I) ratio), the Valsalva manoeuvre, isometric handgrip and orthostatic challenge. A high-risk sub-cohort (n = 21) with subclinical obesity or elevated blood pressure was analysed. Adherence to Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines was maintained.Results  The total study sample comprised 142 participants, including 74 males (52.1%) and 68 females (47.9%). The high-risk subset comprised 11 males (52.4%) and 10 females (47.6%). Resting heart rate was higher in females (74.6 ± 8.2 bpm) than in males (70.1 ± 7.6 bpm; t(140) = 3.39, p = .02), while blood pressure was higher in males (p = .03). Time-domain HRV and reflex indices declined significantly with age (p < .001), with optimal thresholds for autonomic senescence occurring at 47 years (SDNN, area under the curve (AUC) = 0.82) and 49 years (Valsalva, AUC = 0.79). Healthy females exhibited enhanced cardiovagal responses (E:I, Valsalva and 30:15 ratios; p < .05). This female autonomic advantage was entirely blunted in the high-risk subset (n = 21), where autonomic parameters fell below the 5th percentile limits (SDNN = 25 ms, RMSSD = 18 ms, Valsalva ratio = 1.09).Conclusion  Healthy adults exhibit an age-related decline in parasympathetic function and a female-specific cardiovagal advantage. Subclinical cardiometabolic risk factors override these physiological buffers, blunting gender-related protection and accelerating autonomic senescence.
SN  - 0972-7531
SN  - 0976-3260
ER  -