Should heart rate variability be “corrected” for heart rate? Biological, quantitative, and interpretive considerations

Eco J.C. de Geus*, Peter J. Gianaros, Ryan C. Brindle, J. Richard Jennings, Gary G. Berntson

*Corresponding author for this work

Research output: Contribution to JournalReview articleAcademicpeer-review


Metrics of heart period variability are widely used in the behavioral and biomedical sciences, although somewhat confusingly labeled as heart rate variability (HRV). Despite their wide use, HRV metrics are usually analyzed and interpreted without reference to prevailing levels of cardiac chronotropic state (i.e., mean heart rate or mean heart period). This isolated treatment of HRV metrics is nontrivial. All HRV metrics routinely used in the literature exhibit a known and positive relationship with the mean duration of the interval between two beats (heart period): as the heart period increases, so does its variability. This raises the question of whether HRV metrics should be “corrected” for the mean heart period (or its inverse, the heart rate). Here, we outline biological, quantitative, and interpretive issues engendered by this question. We provide arguments that HRV is neither uniformly nor simply a surrogate for heart period. We also identify knowledge gaps that remain to be satisfactorily addressed with respect to assumptions underlying existing HRV correction approaches. In doing so, we aim to stimulate further progress toward the rigorous use and disciplined interpretation of HRV. We close with provisional guidance on HRV reporting that acknowledges the complex interplay between the mean and variability of the heart period.

Original languageEnglish
Article numbere13287
Pages (from-to)1-26
Number of pages26
Issue number2
Early online date25 Oct 2018
Publication statusPublished - Feb 2019


  • autonomic
  • behavioral medicine
  • heart rate
  • heart rate variability


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