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Allostatic load and heart rate variability as health risk indicators.

ABSTRACT: Uncertainty often exists about the comparability of results obtained by different health risk indicator systems.To compare two health risk indicator systems, i.e, allostatic load and heart rate variability (HRV). Additionally, to investigate the feasibility of inclusion of HRV indicators into allostatic load assessments and which HRV indicators are best to introduce.Allostatic loads were calculated based on blood pressure, waist-to-hip ratio, BMI, cholesterol, HDL-C, LDL-C, CRP, albumin, glycosylated haemoglobin, blood glucose and cortisol excretion. Allostatic load scores were compared to HRV results obtained by frequency domain, time domain and Poincaré analyses.Negative correlations were found between allostatic loads and total HRV, for all periods and all HRV analytical techniques (r=-0.67, p=0.0001 to r=-0.435, p=0.035), and between allostatic loads and vagal measures of HRV for supine (r=-0.592, p=0.001 to r=-0.584, p=0.001) and the first 5 minutes standing (r=-0.443, p=0.021 to r=-0.407, p=0.035), with all HRV techniques. Heart rate responses declined with increases in allostatic loads.HRV and allostatic load scores give comparable results as health risk indicators. Baseline total HRV and vagal, rather than sympathetic, measures of HRV should be introduced into allostatic load assessments. Results are in line with the concept of vagal tone as a regulator of allostatic systems. Inclusion of heart rate responses to orthostatic stress, into allostatic load assessments, warrants further investigation.

SUBMITTER: Viljoen M

PROVIDER: S-EPMC5637028 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Allostatic load and heart rate variability as health risk indicators.

Viljoen Margaretha M Claassen Nicolaas N

African health sciences 20170601 2

<h4>Background</h4>Uncertainty often exists about the comparability of results obtained by different health risk indicator systems.<h4>Objectives</h4>To compare two health risk indicator systems, i.e, allostatic load and heart rate variability (HRV). Additionally, to investigate the feasibility of inclusion of HRV indicators into allostatic load assessments and which HRV indicators are best to introduce.<h4>Methods</h4>Allostatic loads were calculated based on blood pressure, waist-to-hip ratio, ...[more]

PMID: 29062338

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Project description:BackgroundAwareness of the cumulative stress placed on first responders and tactical operators is required to manage acute fatigue, which can impair occupational performance, and may precipitate negative chronic health outcomes. The aim of this review was to investigate the utility of heart rate variability (HRV) to monitor stress and allostatic load among these populations.MethodsA systematic search of Academic Search Complete, MEDLINE complete, PsycINFO, SPORTDiscus and Scopus databases was conducted. Eligibility criteria: original peer reviewed research articles, written in English, published between 1985 and 2020, using human participants employed as a first responder or tactical operator, free from any psychological disorder.ResultsOf the 360 articles screened, 60 met the inclusion criteria and were included for full text assessment. Articles were classified based on single or repeated stressor exposure and the time of HRV assessment (baseline, during stressor, post stressor). Singular stressful events elicited a reduction in HRV from baseline to during the event. Stressors of greater magnitude reduced HRV for extended durations post stressor. Lower resting HRV was associated with lower situational awareness and impaired decision-making performance in marksmanship and navigation tasks. There were insufficient studies to evaluate the utility of HRV to assess allostatic load in repeated stressor contexts.ConclusionA reduction in HRV occurred in response to acute physical and cognitive occupational stressors. A slower rate of recovery of HRV after the completion of acute occupational stressors appears to occur in response to stressors of greater magnitude. The association between lower HRV and lower decision-making performance poses as a useful tool but further investigations on within subject changes between these factors and their relationship is required. More research is required to investigate the suitability of HRV as a measure of allostatic load in repeated stress exposures for fatigue management in first responder and tactical operators.

Project description:Background Prevention of hearing loss via addressing potentially modifiable risk factors may offer means of reducing the global burden of hearing loss. Prior studies reported associations between individual markers of inflammation and risk of hearing impairment. Allostatic load is an index of cumulative physiological stressors, including inflammation, to multiple biological systems. Our aims were to investigate associations between allostatic load and both audiometric and self-reported hearing impairment and examine whether associations are stronger over time due to prolonged high allostatic load. Methods Data were taken from the English Longitudinal Study of Ageing (ELSA), a nationally representative study of people aged 50+ living in England over 3 time points between 2008 and 2014. Allostatic load score was comprised of thirteen different measures available at baseline and 4 years post-baseline (high-density lipoprotein/total cholesterol, triglyceride, fibrinogen, haemoglobin A1c, C-reactive protein, insulin-like growth factor 1 (IGF-1), systolic and diastolic blood pressure, mean arterial pressure, resting pulse rate, peak expiratory flow, BMI and waist circumference), measured using clinical cut-off points for normal biomarker parameters. Hearing acuity was measured with a simple handheld tone-producing device at follow-up 7 years post-baseline, while self-reported hearing impairment was measured at time point. Results We included samples of 4373 and 4430 for the cross-sectional and longitudinal analysis, respectively. In the cross-sectional model high allostatic load was associated both self-reported (OR = 1.08, 95% CI 1.0,1.1; p < 0.01) and objective hearing loss (OR = 1.10, 95% CI 1.1,1.2; p < 0.001) adjusting for age and sex. Cross-sectional associations between allostatic load and hearing were not significant after further adjustment for covariates (qualification, physical activity and smoking). In longitudinal modelling, high allostatic load was associated with both audiometric (Z score OR = 1.11, 95% CI 1.1,1.2; p < 0.001) and self-reported hearing impairment (OR = 1.08, 95% CI 1.0,1.1; p < 0.001) adjusting for age and sex. Allostatic load was no longer associated with self-reported hearing loss but the association with audiometric hearing impairment (OR = 1.08, 95% CI 1.03,1.13; p < 0.001) remained following additional adjustment for baseline self-reported hearing, education, physical activity, and smoking. Conclusions Prolonged high allostatic load was associated with risk of hearing impairment. Reducing allostatic load via healthy lifestyle changes including non-smoking, healthy diet and exercise may offer an opportunity to reduce the risk of hearing impairment in later life. Highlights • Allostatic load captures cumulative physiological stress which has consequence for subsequent hearing function.• Prolonged high allostatic load was associated with risk of objectively measured hearing impairment.• This association is shown in nationally representative longitudinal ageing study.

Project description:The objective of this paper is to examine associations between multiple measures of discrimination (i.e., everyday, lifetime, and appraised burden) and components of allostatic load (AL). We drew on pooled cross-sectional data from the Biomarker Project of the Midlife in the United States study (n = 2118). Ages ranged from 25 to 84 years and included mostly Black (n = 389) and white (n = 1598) adults. Quasi-Poisson models were fit to estimate prevalence ratios for each discrimination measure and high-risk quartiles across seven physiological systems (i.e., sympathetic and parasympathetic nervous system; HPA axis; inflammation; cardiovascular; metabolic glucose; and metabolic lipids) and overall AL scores. In fully adjusted models, everyday discrimination was associated with elevated lipids (aPR: 1.07; 95% CI 1.01, 1.13). Lifetime experiences of discrimination were associated with lower sympathetic nervous system (aPR: 0.82; 95% CI: 0.69, 0.98) and greater cardiovascular risk scores (aPR: 1.17; 95% CI: 1.02, 1.34) among those reporting three or more experiences, as well as increased inflammation (aPR: 1.13; 95% CI: 1.02, 1.25; aPR: 1.28; 95% CI: 1.14, 1.43), metabolic glucose (aPR: 1.35; 95% CI: 1.19, 1.54; aPR: 1.45; 95% CI: 1.24, 1.68), and metabolic lipids (aPR: 1.13; 95% CI: 1.03, 1.24; aPR: 1.28; 95% CI: 1.15, 1.43) scores for those reporting one to two and three or more experiences. Appraised burden yielded nuanced associations with metabolic glucose and parasympathetic nervous system scores. Everyday and lifetime measures were also associated with higher overall AL, though burden of discrimination was only associated with AL among those reporting "a little" burden. While AL summary scores provide insight into the cumulative impacts of discrimination on health, there appear to be distinct physiologic pathways through which varying forms of discrimination contribute to AL and, ultimately, to poorer health. These unique pathways may be useful in identifying potential points of intervention to mitigate the impacts of discrimination on health inequities.

Project description:Background:Heart rate variability (HRV) is an indicator of dynamic adaptability of the autonomic nervous system. Few interventions target upstream, cerebral cortex components of the heart-brain system for autonomic management. We report changes in HRV and baroreflex sensitivity (BRS), associated with use of a noninvasive, closed-loop, allostatic, computer-guided, acoustic stimulation neurotechnology. Methods:Over 5?years, 220 subjects with heterogeneous neurological, cardiovascular, and psychophysiological conditions consecutively enrolled in a naturalistic, single-arm study exploring clinical effects associated with use of the neurotechnology. Of those, 202 completed the study protocol and 160 had recordings adequate to analyze HRV and BRS. Mean age was 44.0 (SD 19.4), with 130 women. Participants received a mean of 16.1 (5.2) sessions, over 24.2?days (23.3), with 9.5 (3.8) actual intervention days. Sessions included real-time analysis of brain electrical activity and software algorithm-guided translation of selected frequencies into patterns of acoustic stimulation (audible tones of variable pitch and timing), to facilitate auto-calibration of neural oscillations. Outcomes including 10-min supine, at-rest recordings of blood pressure and heart rate, and inventories for insomnia (ISI) and depression (CES-D or BDI-II), were obtained at baseline and 15.3 (16.7) days after the last session. Results:Compared to baseline, significant increases (all p?<?0.001) were observed for measures of HRV across all participants including the mean percentage change for SDNN 24.2% (SE 0.04), and RMSSD, 42.2% (0.08), and BRS [Sequence Up, 55.5% (0.09), Sequence Down, 77.6% (0.23), and Sequence All, 53.7% (0.07)]. Significant improvements were noted in SAP, MAP, and DAP, as well as natural log of HF, and total power. Self-reported ISI was reduced (ISI, -6.4 points, SD 5.6, p?<?0.001). The proportion reporting clinically significant depressive symptoms reduced from 48.2% at baseline to 22.1% at follow-up. Linear regression showed that rightward asymmetry predicted lower SDNN (p?=?0.02). Exploratory analysis showed a trend for improved balance of temporal lobe high-frequency amplitudes over the course of initial sessions. Conclusion:These findings indicate that use of a noninvasive, allostatic, closed-loop neurotechnology appears to have robust potential for public health efforts to support greater flexibility in autonomic cardiovascular regulation, through self-optimization of electrical activity at the level of the brain.

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Allostatic load and heart rate variability as health risk indicators.

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Allostatic load and heart rate variability as health risk indicators.

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