Heart Rate Variability: Should You Be Concerned?

Heart rate issues

Hello Doctor, I have a question.
I have been wearing an Apple Watch, and over the past year, I measured my sleep heart rate (from midnight to 6 AM) and recorded values of 46-92 bpm, 43-117 bpm, and 51-111 bpm.
The lowest heart rates were in the 40s or 50s.
I didn't pay much attention for a few months, but in February of this year, I measured again and got a reading of 58-84 bpm.
Recently, over the past three days, I found my heart rate to be 59-80 bpm.
I haven't exercised in the past six months, and my lifestyle hasn't changed, but I do have issues with indigestion, headaches, and occasional mild fever.
My concern is that the heart rate curve on my phone seems to have shifted slightly upward.
Should I be worried about this? Thank you!

Athy, 30~39 year old female. Ask Date: 2022/04/14

Dr. Wu Xueming reply Cardiology

It is recommended to maintain a regular daily routine and engage in regular exercise.
However, if you still have concerns, it is advisable to visit a hospital for an electrocardiogram (ECG) examination.

Reply Date: 2022/04/14

More Info

When it comes to heart rate variability (HRV) and its implications for health, especially in the context of your observations with your Apple Watch, there are several important factors to consider. First, it's essential to understand that heart rate variability refers to the fluctuation in the time intervals between consecutive heartbeats. A higher HRV is generally associated with better cardiovascular fitness and resilience to stress, while a lower HRV can indicate stress, fatigue, or potential health issues.

From your data, it appears that your resting heart rate has ranged from the low 40s to the low 90s beats per minute (BPM). While a resting heart rate in the 40s can be normal for well-conditioned athletes, it can also indicate bradycardia (a slower than normal heart rate) in non-athletes. In your case, the variability in your heart rate readings, particularly during sleep, suggests that your heart rate is responding to various factors, including your overall health, stress levels, and possibly your digestive issues.

The fact that you have experienced episodes of low heart rate (in the 40s) and that your heart rate has fluctuated between 58-84 BPM in recent measurements may not be inherently alarming, especially if you are not experiencing symptoms such as dizziness, fainting, or significant fatigue. However, it is crucial to consider the context of your overall health. You mentioned experiencing digestive problems, headaches, and occasional elevated body temperature, which could contribute to your heart rate variability. Stress and anxiety can also impact heart rate, leading to fluctuations that may not necessarily indicate a serious underlying condition.

Given your concerns and the changes in your heart rate patterns, it would be prudent to consult with a healthcare professional. They may recommend further evaluation, such as a Holter monitor to assess your heart rate over a more extended period or an echocardiogram to evaluate your heart's structure and function. These tests can help determine if there are any underlying cardiac issues that need to be addressed.

Additionally, lifestyle factors play a significant role in heart health. If you have not been exercising regularly, incorporating physical activity into your routine can improve cardiovascular fitness and potentially enhance HRV. Moreover, addressing your digestive issues and managing stress through relaxation techniques, mindfulness, or therapy can also positively influence your heart health.

In summary, while your heart rate variability and the observed fluctuations may not be immediately concerning, they warrant further investigation, especially in light of your other health symptoms. Consulting with a healthcare provider will help clarify whether any interventions are necessary and provide you with peace of mind regarding your heart health.

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