Determinants and interindividual variation of R-R interval dynamics in healthy middle-aged subjects

Determinants and inter-subject variations of fractal and complexity measures of R-R interval variability were studied in a random population of 200 healthy middle-aged women (age 51 [+ or -] 6 yr) and 189 men (age 50 [+ or -] 6 yr) during controlled conditions in the supine and sitting positions. The short-term fractal exponent ([[Alpha].sub.1]) was lower in women than men in both the supine (1.18 [+ or -] 0.20 vs. 1.12 [+ or -] 0.17, P [is less than] 0.01) and sitting position (P [is less than] 0.001). Approximate entropy (ApEn), a measure of complexity, was higher in women in the sitting position (1.16 [+ or -] 0.17 vs. 1.07 [+ or -] 0.19, P [is less than] 0.001), but no gender-related differences were observed in ApEn in the supine position. Fractal and complexity measures were not related to any other demographic, laboratory, or lifestyle factors. Intersubject variations in a fractal measure, [[Alpha].sub.1] (e.g., 1.15 [+ or -] 0.20 in the supine position, z value 1.24, not significant), and in a complexity measure, ApEn (e.g., 1.14 [+ or -] 0.18 in the supine position, z value 1.44, not significant), were generally smaller and more normally distributed than the variations in the traditional measures of heart rate variability (e.g., standard deviation of R-R intervals 49 [+ or -] 21 ms in the supine position, z value 2.53, P [is less than] 0.001). These results in a large random population sample show that healthy subjects express relatively little interindividual variation in the fractal and complexity measures of heart rate behavior and, unlike the traditional measures of heart rate variability, they are not related to lifestyle, metabolic, or demographic variables. However, subtle gender-related differences are also present in fractal and complexity measures of heart rate behavior. gender; heart rate variability; nonlinear methods; risk factors