Does my heart rate variability (HRV) tell me anything about my health?
A higher HRV is associated with better health and greater resilience. Slow breathing is the most accessible and best-supported way to work on that yourself.
HRV measures how much the time between successive heartbeats varies. That variation is not noise: it reflects how flexibly your autonomic nervous system operates, the part that unconsciously regulates your heart rate, breathing and digestion. A higher HRV is associated with greater adaptability to stress and better overall health. But it remains a signal, not a direct cause: you cannot simply draw causal conclusions from it1,2.
How clinically useful HRV can be is illustrated by a study of 271 hospitalised COVID-19 patients. In patients aged 70 and older, a higher HRV at admission was associated with a greater chance of survival and a lower chance of intensive care admission in the first week. In younger patients this association was absent. This is observational research, so causality has not been proven. But it shows that HRV can provide useful additional information for vulnerable older patients2.
If you want to influence your own HRV, slow breathing is the best-supported approach. A meta-analysis of 223 studies shows that it raises HRV, both during and immediately after a breathing session and after a longer series of sessions. It costs nothing, requires no equipment and has few side effects3.
HRV biofeedback, in which you learn to consciously steer your heart rhythm with the help of a device, also has a broad evidence base. A meta-analysis of 58 randomised studies shows small to moderate positive effects on anxiety, depression, anger and athletic performance. For sleep and quality of life the effects are smaller. Researchers therefore view it as a complement to existing care, not a replacement4. A smaller study of 76 people compared five weeks of HRV biofeedback, mindfulness meditation and physical exercise: all three reduced stress, anxiety and sleep problems, with no clear difference between them5.
Music as a way to raise HRV has also been studied. Different genres can activate or calm the nervous system, but the effects are inconsistent and depend strongly on the type of music. The quality of the available studies is too low to recommend music as a serious intervention. For the time being, people looking to improve their HRV have little to gain from it6.
The claims are based on one large meta-analysis on slow breathing (223 studies, PMID 35623448), one meta-analysis on HRV biofeedback (58 randomised studies, PMID 32385728), one randomised study with 76 participants (PMID 26111942), one retrospective cohort study in COVID-19 patients with 271 participants (PMID 34710127), one review on music (PMID 34237410) and one review article on HRV as a health signal (PMID 39625562). Most associations are observational; for slow breathing the causal evidence is stronger.
What does my blood pressure say about my long-term health?
A structurally high or strongly fluctuating blood pressure substantially increases your risk of stroke, heart attack and premature death. Small adjustments such as eating less salt and measuring regularly make a demonstrable difference.
What does my CRP value (inflammation) say about my heart?
A high hsCRP value points to chronic inflammation and predicts a clearly elevated long-term risk of cardiovascular problems, even more strongly than well-known cholesterol values. It is an independent risk factor that deserves serious attention.
Does your resting heart rate say anything about how fast you are ageing?
A structurally high resting heart rate, certainly above 80 to 90 beats per minute, is associated with a clearly higher risk of premature death. Exercising to lower your resting heart rate is worthwhile, but a very low heart rate at an older age is not always a good sign: if in doubt, discuss it with your doctor.
How healthy are my blood vessels / what is my vascular age?
For a first impression of your vascular health, an ApoB blood test is the simplest and most accessible step; a CAC scan adds the most value when your risk remains unclear after blood testing.
Does having bad gums affect my heart?
There is a plausible association between severe gum disease and heart problems, but no proven causal relationship. Good oral care is sensible, but whether treating gum disease lowers your cardiac risk has not yet been demonstrated.
Is your oral health linked to cardiovascular disease?
Serious gum disease is demonstrably associated with a higher risk of cardiovascular disease and high blood pressure; that is a good reason to take oral health seriously and have gum complaints treated promptly.