Clinical Science (2003) 104, 295-302 - M. Vaz and others - Undernutrition and heart rate variability

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Clinical Science (2003) 104, (295–302) (Printed in Great Britain)

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Heart rate variability and baroreflex sensitivity are reduced in chronically undernourished, but otherwise healthy, human subjects

Mario VAZ, A.V. BHARATHI, S. SUCHARITA and D. NAZARETH

Division of Nutrition and Department of Physiology, St John's Medical College, Bangalore 560034, India

Abbreviations: BMI, body mass index; PAL, physical activity level; SBP, systolic blood pressure; NW/WN, normal weight, well nourished; UW/UN, underweight, undernourished; UW/WN, underweight, well nourished.

Alterations in autonomic nerve activity in subjects in a chronically undernourished state have been proposed, but have been inadequately documented. The present study evaluated heart rate and systolic blood pressure variability in the frequency domain in two underweight groups, one of which was undernourished and recruited from the lower socio-economic strata [underweight, undernourished (UW/UN); n = 15], while the other was from a high class of socio-economic background [underweight, well nourished (UW/WN); n = 17], as well as in normal-weight controls [normal weight, well nourished (NW/WN); n = 27]. Baroreflex sensitivity, which is a determinant of heart rate variability, was also assessed. The data indicate that total power (0–0.4Hz), low-frequency power (0.04–0.15Hz) and high-frequency power (0.15–0.4Hz) of RR interval variability were significantly lower in the UW/UN subjects (P<0.05) than in the NW/WN controls when expressed in absolute units, but not when the low- and high-frequency components were normalized for total power. Baroreflex sensitivity was similarly lower in the UW/UN group (P<0.05). Heart rate variability parameters in the UW/WN group were generally between those of the UW/UN and NW/WN groups, but were not statistically different from either. The mechanisms that contribute to the observed differences between undernourished and normal-weight groups, and the implications of these differences, remain to be elucidated.