Listen to your head and your heart: Heart Rate Variability 101

Pop duo Roxette said it best: Listen to your heart. Words of wisdom to remember this Valentine’s Day. And, excellent advice when it comes to taking care of your health. In fact, listening to your heart can help you understand what is going on in your head!

One biomarker to rule them all

It’s no secret that doctors encourage patients to place high importance on maintaining heart health. And for good reason – heart disease is still the leading cause of death is the US. Keeping a close eye on biomarkers like cholesterol, heart rate, and blood pressure just comes with the territory of aging. But you could be skipping over a key biomarker that serves as a broad indicator of overall physical and psychological health for people of all ages: heart rate variability.

An introduction to Heart Rate Variability

Heart Rate Variability (HRV) is a measure of the variation in the time between individual heart beats. Rather than simply counting how many times your heart beats per minute, HRV measures how consistent the length of time between each beat is. HRV helps doctors understand if your heart is beating in a simple and predictable pattern, like a metronome, or in a more variable pattern.

  • Low HRV means your heart beats like a metronome and the length of time between each heart beat is nearly identical.
  • High HRV means your heart beats with intervals of varying length.

Although many people assume that a steady, consistent pattern of heart beats (low variability/low HRV) indicates good health, the opposite is actually true. Yes, you read that right — high HRV is a sign of good physical and psychological health! Think of it this way: a healthy heart pumps as needed. It responds to the demands of the body in real time and doesn’t follow a predictable interval.

So, HRV reflects general heart health. But, it does more than that; it also tells us about the state of one’s autonomic nervous system1. This is the part of the nervous system in control of “automatic” (hence autonomic) functions like blood pressure, breathing rate, arousal and digestion. HRV gives us insight to this very valuable aspect of our health that is otherwise very difficult to assess and monitor.

The Autonomic Nervous System: Linking your head and your heart

There is a lot going on in your body that is controlled by the autonomic nervous system. For example, you don’t think about making your heart beat faster or slower – it happens automatically in response to your environment. Because you don’t think about contracting your heart muscles, we say this is an “autonomic” (automatic) function.

In general, low HRV indicates that the sympathetic response is dominant in your autonomic nervous system. This means your body is continually primed for ‘fight or flight’, and you may experience feelings of stress, anxiety, poor sleep or stomach aches.

In contrast, high HRV indicates that the sympathetic (fight or flight) and the parasympathetic response (rest and digest) are well balanced. In this balanced state, your body can easily shift between intense states and calm recovery states in order to maintain balance throughout the day and the night.   This means that you can relax, concentrate, be productive, be active, sleep, and recover. Overall, high HRV indicates better physical and psychological well-being.

How does HRV impact your health?

Low HRV has been identified as a risk factor for several cardiac diseases, including heart attack and congestive heart failure2. And in addition to being an indicator of heart health, HRV is an indicator of resilience. It tells doctors how easily you can handle and bounce back from psychological stressors (like a crazy work week) and physical stressors (like a hard workout at the gym). Low HRV has been linked to negative emotions like hostility and anxiety, clinical depression, and PTSD. On the other hand, high HRV is associated with adaptability, resilience, and healthy longevity3 – the kind of graceful aging that we all desire. With all these benefits of measuring heart health and physical recovery, it’s no wonder why HRV is used to track the health status of patients and elite athletes alike!

What can you do to achieve a high HRV?

By regularly tracking your HRV at home, you can be in tune with your autonomic nervous system. It can help you identify stressors you didn’t even realize were stressors. It can help you decide if your body needs a challenging workout or a day off. And it can give you insight to what is going on in your head.

Once you’ve begun monitoring your HRV, here are three strategies to help you improve it:

  1. Exercise. Many studies have shown that exercise increases HRV. A simple approach? Take a nature walk4! It will be enough exercise to improve HRV without accumulating excess stress in your body. But be sure to give your body enough time to recover after a workout – low HRV is associated with poor strength and aerobic performance5.
  2. HRV biofeedback is a way to become consciously aware of our automatic body functions and train them so we have more control over our health. It has been used to help treat a variety of issues including anxiety, depression, PTSD, hypertension, and cardiac rehabilitation after heart attack6,7. You can use tools like the Waveband, a wrist wearable monitor to track and train your HRV.
  3. Mindfulness-based therapeutic approaches help people focus on the present. Breathing exercises, relaxation techniques, and mindfulness meditations have helped patients with anxiety and depression reduce their symptoms and balance their emotions8.

The good news about these options? It doesn’t matter which one you choose! Physical activity, HRV biofeedback, and mindfulness are all equally effective in reducing stress and its related symptoms9, which will have your HRV climbing in no time.

This Valentine’s Day, we are following Roxette’s advice. It’s time to listen to our hearts. And we encourage you to do the same – it’ll help you understand your head!


1 Larsen HR. Heart Rate Variability and Atrial Fibrillation. The AFIB Report.

2 Task Force of the European Society of Cardiology, North American Society of Pacing and Electrophysiology. (1996) Heart Rate Variability: Standards of measurement, physiological interpretation, and clinical use. European Heart Journal. 17:354-381.

3 Silfigar U, Jurivich DA, Gao W, Singer DH. (2010) Relation of high heart rate variability to healthy longevity. Am J Cardiol. 105(8):1181-5.

4 Gladwell VF, et al. (2016) A Lunchtime Walk in Nature Enhances Restoration of Autonomic Control during Night-Time Sleep: Results from a Preliminary Study. International Journal of Environmental Research and Public Health. 13(3): 280.

5 Chen JL, et al. (2011) Parasympathetic nervous activity mirrors recovery status in weightlifting performance after training. The Journal of Strength & Conditioning Research. 25(6):1546-1552.

6 Berry ME. (2010) Cardiac coherence and posttraumatic stress disorder in combat veterans. Alternative Therapies in Health and Medicine. 16(4):52.

7 Gevirtz R. (2013) The promise of heart rate variability biofeedback: evidence-based applications. Biofeedback 41(3):110-120.

8 Burg JM, Wolf OT, Michalak J. (2012) Mindfulness as self-regulated attention: Associations with heart rate variability. Swiss Journal of Psychology 71.3: 135-139.

9 Van der Zwan JE, de Vente W, Huizink AC, Bogels SM, de Bruin EL. (2015) Physical activity, mindfulness meditation, or heart rate variability biofeedback for stress reduction: A randomized control trial. Appl Psychophysiol Biofeedback. 40(4):257-68.