What is the association between heart rate variability (HRV) and the risk of all-cause death or cardiovascular events in patients with cardiovascular disease (CVD)?
Heart-Rate-Variability & Autonomic Tools, a meta-analysis in 3,094 participants (Biol Res Nurs 2019, PMID 31558032) — lower HRV was associated with a higher risk of all-cause death (pooled HR 2.27, 95% CI: 1.72, 3.00) and cardiovascular events (pooled HR 1.41, 95% CI: 1.16, 1.72). Scope: 3,094 participants, and the abstract states no limitations.
Source: Biol Res Nurs 2019, PMID 31558032 ↗ · Research map · How Magellan grades evidence · evidence confidence: medium
Biol Res Nurs · 2019 · PMID 31558032 · DOI 10.1177/1099800419877442
Lower heart rate variability is linked to a higher risk of death and cardiovascular problems in people with heart disease.
The question
What is the association between heart rate variability (HRV) and the risk of all-cause death or cardiovascular events in patients with cardiovascular disease (CVD)?
What they tested
Lower heart rate variability (HRV) is associated with a higher risk of cardiovascular events and mortality.
How they did it
A meta-analysis of 28 cohort studies involving 3,094 participants was conducted. Four databases (PubMed, MEDLINE, Embase, and Cochrane Central Register of Controlled Trials) were searched to extract adjusted hazard ratios (HR) from eligible studies with a follow-up of at least 1 year.
What they found
Lower HRV was associated with a higher risk of all-cause death (pooled HR 2.27, 95% CI: 1.72, 3.00) and cardiovascular events (pooled HR 1.41, 95% CI: 1.16, 1.72). Subgroup analysis showed a significant pooled HR for all-cause death in patients with acute myocardial infarction (AMI) but not heart failure. For cardiovascular events, the pooled HR was significant for patients with AMI and acute coronary syndrome, but not for those with coronary artery disease and heart failure. Both time and frequency domains of HRV were significantly associated with risk.
| All-Cause Death | 2.27 | |
|---|---|---|
| Cardiovascular Events | 1.41 |
Pooled Hazard Ratios indicate the increased risk associated with lower heart rate variability.
What it means
Lower heart rate variability is significantly associated with an increased risk of all-cause death and cardiovascular events in patients with cardiovascular disease, particularly in those with acute myocardial infarction and acute coronary syndrome.
Limitations
The abstract does not explicitly state limitations of the meta-analysis.
Where the published abstract does not list limitations, we say so rather than inventing them. Read the full paper on PubMed before drawing conclusions.
The paper at a glance
| Title | Heart Rate Variability and Risk of All-Cause Death and Cardiovascular Events in Patients With Cardiovascular Disease: A Meta-Analysis |
|---|---|
| Journal | Biol Res Nurs |
| Year | 2019 |
| PMID | 31558032 ↗ |
| DOI | 10.1177/1099800419877442 ↗ |
| Topic | Cardiovascular & vascular aging |
Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗
Where Magellan uses this paper
This citation sits behind the evidence grade on the pages below. Grades are set from the research and are independent of affiliate commissions.
Biometric Wearables (Sleep, HRV & Recovery)
Across brands, independent validations find these devices agree closely with polysomnography for sleep-versus-wake detection and with ECG for heart rate and time-domain HRV (RMSSD), while four-stage sleep staging is only moderate (roughly 50-75% agreement) and energy-expenditure estimates are poor;
Heart-Rate-Variability & Autonomic Tools
Higher HRV reflects a flexible, resilient autonomic nervous system, and reduced HRV is associated in research with worse outcomes including all-cause mortality. Tracking and training HRV provides a non-invasive readout of stress, recovery and cardiovascular health over time.
Consumer biometric wearables—smartwatches, wrist-worn bands and finger rings from makers such as Apple…
Consumer biometric wearables—smartwatches, wrist-worn bands and finger rings from makers such as Apple…
Consumer biometric wearables—smartwatches, wrist-worn bands and finger rings from makers such as Apple…
Consumer biometric wearables—smartwatches, wrist-worn bands and finger rings from makers such as Apple…
Consumer biometric wearables—smartwatches, wrist-worn bands and finger rings from makers such as Apple…
Consumer biometric wearables—smartwatches, wrist-worn bands and finger rings from makers such as Apple…
Research describes the compound or intervention studied. It is not a claim about any specific product.
Molecules & mechanisms in this paper
Each of these is named in the paper’s own words above. Open the monograph for the full mechanism and its other citations.
Cite this page
These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.
Magellan Longevity. (2026). What is the association between heart rate variability (HRV) and the risk of all-cause death or cardiovascular events in patients with cardiovascular disease (CVD)? [Plain-English summary of Biol Res Nurs 2019, PMID 31558032, DOI 10.1177/1099800419877442]. Magellan Longevity. https://magellanlongevity.com/study/x13.html@misc{magellan_x13,
title = {What is the association between heart rate variability (HRV) and the risk of all-cause death or cardiovascular events in patients with cardiovascular disease (CVD)?},
author = {{Magellan Longevity}},
year = {2026},
howpublished = {\url{https://magellanlongevity.com/study/x13.html}},
note = {Plain-English summary of PubMed PMID 31558032; DOI 10.1177/1099800419877442; Biol Res Nurs 2019. Reviewed by Gabriel Radu, DO},
urldate = {2026-08-11}
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