A Data-Informed Understanding of Mind-Body Medicine with Heart Rate Variability

In traditional medical circles, there can be a discrediting attitude around the topic of mind-body medicine and the role of stress in physical ailments. Most of us in medicine are trained to seek hard scientific evidence before accepting health or medical information whereas mind-body phenomena may reside comfortably in spiritual or mystic communities.

Some of this discrediting attitude resulted from early research on the role of stress in physical ailments. The research failed to show a significant association between higher-strung personality type As or more relaxed personality type Bs and cardiovascular disease outcomes.  More research credibility was given to the topic in the 1980s and 1990s when a significant association was reported between post-cardiac event depression and adverse events leading to the acknowledgment of an emotional condition as a cardiac risk factor or trigger.

For decades, I have noted powerful associations between stress and cardiovascular outcomes in my patients with hypertension, angina, cardiac arrest, and heart attack, and in a life-threatening condition called Takotsubo syndrome or broken heart syndrome. However, I found that individuals with seemingly comparable stress did not, in all cases, develop adverse outcomes.  What is stress to one person might be excitement to another. How one person relieves stress or achieves resiliency is entirely different from the strategies of another. I came to realize that the physiology of stress and relaxation or recovery are highly individual.

Over time, the physiologic literature surrounding cardiovascular and autonomic nervous system interactions furthered my understanding of mind-body medicine, or what I sometimes referred to as heart-brain medicine. Heart rate variability (HRV) is a measure of cardiovascular and autonomic nervous system balance that is distinct and separate from commonly known heart rate or arrhythmia monitoring and the clinical grade validated technology to measure HRV has now come to maturity. 

Research has increasingly associated everyday lifestyle behaviors with positive or negative HRV patterns. Intriguing psychological studies demonstrate the neurological aspects of meditative practices, whether grounded in spirituality, positive psychology, progressive muscular relaxation, breathing exercises, and patterns of HRV. Scientific literature has also tied too much exercise training or too little recovery to adverse HRV and sports performance for elite athletes. And HRV patterns help discern whether hours slept are restorative or simply a numeric duration.

I experience different HRV recordings based on my mindset, how I move, how I nourish myself, how I relate to others, and particularly related to how I sleep. This personalized and data-informed way of assessing baseline mind-body physiology and tracking results of stepwise lifestyle changes is highly illuminating for each individual. 

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