The influence of anxiety disorders on heart rate variability – Implications for clinical management

Anxiety disorders have become a major topic of interest, extensively studied from the perspective of pathophysiology and the factors contributing to their onset and progression. The goal is to identify new methods for early diagnosis and effective treatment. Anxiety has been shown to be a major factor in autonomic dysregulation, significantly impacting heart rate variability (HRV). This study examines the bidirectional relationship between anxiety disorders and HRV, exploring the underlying pathophysiological mechanisms. The neurovisceral integration model demonstrates that prefrontal cortical dysfunction, commonly found in anxiety disorders, leads to impaired inhibitory control over subcortical autonomic centers. This dysfunction results in reduced vagal tone and decreased HRV. Additionally, the polyvagal theory explains the role of the vagus nerve in inhibiting stress-related physiological responses by modulating adaptive physiological reactions. This suggests that vagal regulatory deficits observed in individuals with anxiety contribute to autonomic rigidity and maladaptive behavioral patterns. An increasing number of studies are investigating the genetic basis of HRV and the pathophysiological mechanisms influencing it. Research has demonstrated the existence of genetic variants that can predict both the risk of developing anxiety disorders and changes in HRV. For instance, the Val/Val genotype, frequently found in patients with anxiety, has been associated with HRV impairment. The clinical implications of these findings are significant, as they reveal that decreased HRV is linked to an increased risk of cardiovascular mortality. Understanding the relationship between anxiety and HRV may pave the way for new therapeutic targets and improved management strategies for patients suffering from anxiety disorders.