Evaluation of Low Vagally-Mediated HRV as an Early Marker of Risk for Depression

Introduction: Cross-sectional and prospective studies have shown depression to be associated with low vagally-mediated heart rate variability (HRV); both are risk factors for cardiovascular disease. We recently identified an HRV cut point below which persons have increased risk for several cardiometabolic disorders. However, no such cut point exists to identify those at risk for depression. Objective: To assess the association between HRV and the five item World Health Organization Well-being Index (WHO-5) and identify an HRV cut point to identify those at greater risk of depression. Methods: Depression was assessed using the WHO-5. HRV was assessed by the root mean square successive differences (RMSSD) in milliseconds (ms). A total of 9973 employees (19.39% female) were included (mean age 41.9, SD 10.9; RMSSD mean 27.6ms, SD 12.2). Logistic regression models were calculated to compare the clinically depressed (WHO-5 ≤ 28; 3.7%) to the rest of the population. Results: For RMSSD, a value of 25 ± 2 ms and below indicated elevated risk for major depressive disorder in WHO-5 ≤ 28 and a value of 35 ± 2 ms and below indicated elevated risk for subclinical depression in WHO-5 ≤ 50). Conclusions: The results of the present study provide support for values of RMSSD that can be used to indicate those at risk for depression based on the widely used WHO-5. As HRV is a brief measure that can be used in a clinical setting, HRV may be useful for identifying those at risk for psychological disorders, as well as cardiometabolic disorders.