Revisiting nonlinearity of heart rate variability in healthy aging

Aging is commonly regarded as a physiological process in which the dynamic complexity of physiological time series and organ systems is gradually lost. This notion is derived from the identification of a decline of nonlinear measures with the advance of aging. However, additional research on cardiovascular control studied through heart rate variability (HRV), i.e., the instantaneous changes in heart rate, shows that despite the constriction of its statistical distribution, the nonlinear organization remains present in advanced age. Here, we used surrogate data testing to investigate the presence of nonlinear information in HRV time series from a publicly available database of 1121 healthy human subjects from 18 to 92 years old. We also studied the influence of basic clinical features, such as sex, body mass index (BMI), and mean heart rate (HR), on such nonlinear information. We found that the percentage of nonlinear time series after 30 years of age diminishes significantly (p < 0.01). Furthermore, larger BMI and HR are associated with the presence of more linear information in HRV, while the female sex is associated with the manifestation of nonlinear information. This work provides a common background for the contextualized interpretation of nonlinear testing and shows that the nonlinear content of HRV time series diminishes through aging.