Heart rate variability in postmenopause

Autonomic nervous system and heart rate variability. Both dysregulation of the autonomic nervous system (ANS) and menopause are associated with a higher cardiovascular risk. The cardiac ANS can be assessed by means of heart rate variability (HRV), as the variation between consecutive RR intervals is influenced by parasympathetic and sympathetic mediators. Effects of menstrual cycle phases. During the menstrual cycle, a cycle-dependent HRV fluctuation has been found, and a HRV reduction occurs upon estrogen withdrawal after menopause. Postmenopausal HRV reduction is associated with a higher sympathetic tone and is accompanied by a higher cardiovascular risk. Recent findings suggest a role of the sympathetic drive in the genesis of menopausal hot flashes, as an abrupt reduction of the parasympathetic tone with a predominance of the sympathetic tone occurs during a hot flash. Therapy. Hormone replacement therapy may restore the autonomic balance. However, type and combination of hormones may be crucial.