Heart rate variability is an important biomarker on account of the fact that it reflects the relationship between nervous system balance and chronic stress and chronic inflammation.
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As has been discussed in past articles, two of the most important determinants of our overall metabolic health are chronic stress and chronic inflammation. When there is elevation of one or both of these elements, it is often the case that there will be onset of metabolic dysfunction. If this persists over time, there can be development of metabolic syndrome. As has been noted in past articles, this condition is associated with numerous adverse health impacts, including high blood pressure, high blood sugar, excess abdominal body fat, and abnormalities in cholesterol and triglyceride levels. This in turn leads to an elevated risk of heart disease, stroke, type two diabetes, neurodegenerative conditions, as well as emotional and psychological conditions.
The psychological skills and body-based skills, including somatic practices and complementary approaches to improve cellular and mitochondrial health, are intended to reduce chronic stress and chronic inflammation. In so doing these strategies contribute towards the pursuit of health, wellbeing, and sustainable high performance. In order to adjust the specific strategies being employed, an individualized understanding of the situation is necessary. This allows for an individual specific approach to implementing routines, strategies, and tactics to best address each person‘s individual needs to reduce chronic stress and chronic inflammation. An important component to this approach is a method to establish a baseline status as well as assess changes over time. This information is necessary in order to make changes and revisions to the overall plan on the basis of data regarding the impact of the strategies utilized to date.
Heart rate variability (HRV) has been discussed in past articles. This metric can be measured using continuous wearable devices or other devices for periodic measurement. In addition, HRV can be measured at rest as well as in response to high demand situations and recovery from such scenarios. The importance of measuring HRV lies in its reflection of our degree of nervous system balance. Typically, as we improve nervous system balance we will spend more time in anchored and grounded states. In addition, our nervous system will respond to high demand scenarios by shifting into mobilized, protective, or defensive states as needed, but then shift back towards anchored and grounded states once the situation has resolved.
The important topic of nervous system balance was discussed in the past article. One additional consideration is that a balanced nervous system is necessary in order to best reduce chronic stress and chronic inflammation. Chronic stress and chronic inflammation are both in many ways the result of persistent and continuous activation of the sympathetic nervous system. Chronic inflammation often also results from an insufficient amount of vagus nerve activation of the cholinergic anti-inflammatory pathway. Both scenarios reflect a decrease in nervous system balance.
Given the understanding described above, in order to best address chronic inflammation and chronic stress, it is important to improve nervous system balance. HRV can provide important information in order to be able to individualize strategies and tactics in this regard. This is due to the ability of HRV to reflect the extent of nervous system balance.
The understanding of the means by which HRV reflects chronic stress is readily appreciated. As chronic stress ultimately is the result of chronic sympathetic nervous system activation, HRV can provide direct information with respect to this factor. In situations in which there is persistent elevation and activation of the sympathetic nervous system, there will be reduced HRV on account of the corresponding decrease in vagus nerve activation and the corresponding influence over heart rate.
The relationship between HRV and chronic inflammation requires more description. There are numerous studies which have demonstrated that HRV can be used as an indicator of inflammation as it is strongly correlated with blood test markers of inflammation, such as C- reactive protein. With this information in hand, we can readily appreciate how HRV becomes a marker of inflammation since it can be used as a surrogate marker of blood tests of chronic inflammation. HRV is influenced by vagus nerve activation which also contributes to decreasing inflammation through stimulating the cholinergic anti-inflammatory pathway. For this reason, a reduction in vagus nerve activation will lead to both a decrease in HRV and a decrease in anti-inflammatory function, thereby leading to increased inflammation. Furthermore, HRV is more dynamic than a blood test as it can be measured continuously and repeatedly over time. Blood tests can only be measured at discreet time points. As such they represent a snapshot in time rather than a dynamic understanding over time. For the reason discussed above, HRV is also a better reflection of overall nervous system balance, thereby providing information not only with respect to chronic inflammation, but also chronic stress.
By using HRV as a marker of both chronic stress and chronic inflammation, it can be used to provide a reflection of overall health status. As HRV increases when there is greater vagus nerve stimulation, this reflects a corresponding increase in activation of the cholinergic anti-inflammatory pathway. In addition, vagus nerve stimulation has been shown to improve mitochondrial function. Therefore HRV data can provide important indicators with regards to our metabolic health.
It is important to consider that inflammation is an adaptive response. When we sustain a tissue injury, for example, inflammation is an initial mechanism through which the body response to heal the damage is initiated. In fact, initial inflammation is essential for tissue repair. The problematic nature of inflammation develops when it is persistent over time. In order for inflammation to be adaptive and productive, the response must return to baseline in order to avoid persistent damage. This concept is similar to that of nervous system balance in which we do not want to avoid shifts into mobilized, protective, and defensive states, but rather titrate and modulate those shifts to be appropriate in intensity and duration to the stimulus we experience. Similarly, the inflammatory response is adaptive and essential for tissue recovery and repair. What we are seeking is to avoid persistent and chronic inflammation. For the reasons described above, HRV can provide important information with regards to the degree to which our inflammatory response is adaptive in nature.
The pursuit of health, wellbeing, and sustainable high performance is dependent upon an underlying foundation of metabolic health. In order to accomplish this, reduction of both chronic inflammation and chronic stress is essential. This is also a requirement in order to perform at our highest level, thereby allowing us to pursue sustainable high performance. HRV becomes an important metric to provide information regarding chronic stress and chronic inflammation. Given that it can be non-invasively and continuously measured over time, it is a more dynamic and representative marker of our underlying state of chronic stress and chronic inflammation than are other markers, such as blood tests.
To learn more, including about biologically complementary coaching for healthcare professionals and others in high demand domains, please visit www.darindavidson.com.
Dr. Darin Davidson partners with Learner+, a CME/CE reflective learning platform for healthcare providers. For the opportunity to reflect on this article and earn CME/CE credits, Launch here. Check out all past articles which are also eligible for reflections and CME/CE credits.
For downloadable, actionable strategies and tactics to leverage biology in the pursuit of health, wellbeing, and sustainable high performance, visit the resource store, Launch here. Chapters are arranged by topic so those of interest can be selected and each are also eligible for reflections and CME/CE credits through Learner+.