Perceived Subjective Stress and its Association with 5-min Electrocardiogram-based Heart Rate Variability in Middle-aged Women of an Urban Area of West India

Background: Midlife health poses stress to women. Perceived Stress Scale (PSS) score allows subjective assessment of perceived stress whereas heart rate variability (HRV) gives electrocardiogram (ECG)-based quantification of cardiac autonomic function, but the relation between these two is scarcely...

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Main Authors: Jayesh Dalpatbhai Solanki, Krina Ashish Atodaria, Divyang Rajeshkumar Joshi, Chhaya Maheshbhai Ghodadara, Jinesh Parmar
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-04-01
Series:Journal of Mid-Life Health
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Online Access:https://journals.lww.com/10.4103/jmh.jmh_207_24
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author Jayesh Dalpatbhai Solanki
Krina Ashish Atodaria
Divyang Rajeshkumar Joshi
Chhaya Maheshbhai Ghodadara
Jinesh Parmar
author_facet Jayesh Dalpatbhai Solanki
Krina Ashish Atodaria
Divyang Rajeshkumar Joshi
Chhaya Maheshbhai Ghodadara
Jinesh Parmar
author_sort Jayesh Dalpatbhai Solanki
collection DOAJ
description Background: Midlife health poses stress to women. Perceived Stress Scale (PSS) score allows subjective assessment of perceived stress whereas heart rate variability (HRV) gives electrocardiogram (ECG)-based quantification of cardiac autonomic function, but the relation between these two is scarcely studied. Hence, the association between PSS and HRV was studied in middle-aged women. Methodology: A cross-sectional study was done in midlife premenopausal (n = 51), perimenopausal (n = 59), and postmenopausal (n = 82) women. Perceived stress was interviewed by PSS score. ECG-based 5 min HRV was done by Variowin HR Software for frequency domain, time domain, and geometric HRV parameters. PSS and HRV were further compared or associated in subgroups, taking P < 0.05 as statistically significant. Results: HRV was reduced in all three groups which had a prevalence of PSS grade 0, 1, 2 44%, 53%, and 3%, respectively, without intergroup difference. Diabetic and/or hypertensive subgroups exhibited reduced HRV than nondiabetic nonhypertensive subgroups. No significant correlation was found between PSS score and HRV parameters in either group. HRV did not associate with PSS grade-based subgroups in pre-, peri-, or postmenopausal stage. Conclusion: Lack of HRV to perceived subjective stress association was observed in 40–55-year-old women with mild confounding by diabetes and/or hypertension. We suggest HRV total power and low-frequency: high-frequency ratio as best HRV parameters and consideration of age, reproductive health stage, and presence of comorbidities as a weak confounder for both HRV and PSS studies of middle-aged women. Further studies are warranted to consolidate the utility of HRV and PSS for the assessment of these two different types of stress.
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spelling doaj-art-29ae28ef22934d1d97bc21cc3d0d0b852025-08-20T03:31:48ZengWolters Kluwer Medknow PublicationsJournal of Mid-Life Health0976-78000976-78192025-04-0116219220010.4103/jmh.jmh_207_24Perceived Subjective Stress and its Association with 5-min Electrocardiogram-based Heart Rate Variability in Middle-aged Women of an Urban Area of West IndiaJayesh Dalpatbhai SolankiKrina Ashish AtodariaDivyang Rajeshkumar JoshiChhaya Maheshbhai GhodadaraJinesh ParmarBackground: Midlife health poses stress to women. Perceived Stress Scale (PSS) score allows subjective assessment of perceived stress whereas heart rate variability (HRV) gives electrocardiogram (ECG)-based quantification of cardiac autonomic function, but the relation between these two is scarcely studied. Hence, the association between PSS and HRV was studied in middle-aged women. Methodology: A cross-sectional study was done in midlife premenopausal (n = 51), perimenopausal (n = 59), and postmenopausal (n = 82) women. Perceived stress was interviewed by PSS score. ECG-based 5 min HRV was done by Variowin HR Software for frequency domain, time domain, and geometric HRV parameters. PSS and HRV were further compared or associated in subgroups, taking P < 0.05 as statistically significant. Results: HRV was reduced in all three groups which had a prevalence of PSS grade 0, 1, 2 44%, 53%, and 3%, respectively, without intergroup difference. Diabetic and/or hypertensive subgroups exhibited reduced HRV than nondiabetic nonhypertensive subgroups. No significant correlation was found between PSS score and HRV parameters in either group. HRV did not associate with PSS grade-based subgroups in pre-, peri-, or postmenopausal stage. Conclusion: Lack of HRV to perceived subjective stress association was observed in 40–55-year-old women with mild confounding by diabetes and/or hypertension. We suggest HRV total power and low-frequency: high-frequency ratio as best HRV parameters and consideration of age, reproductive health stage, and presence of comorbidities as a weak confounder for both HRV and PSS studies of middle-aged women. Further studies are warranted to consolidate the utility of HRV and PSS for the assessment of these two different types of stress.https://journals.lww.com/10.4103/jmh.jmh_207_24autonomiccardiacmenopausemiddle-agedpsychological stress
spellingShingle Jayesh Dalpatbhai Solanki
Krina Ashish Atodaria
Divyang Rajeshkumar Joshi
Chhaya Maheshbhai Ghodadara
Jinesh Parmar
Perceived Subjective Stress and its Association with 5-min Electrocardiogram-based Heart Rate Variability in Middle-aged Women of an Urban Area of West India
Journal of Mid-Life Health
autonomic
cardiac
menopause
middle-aged
psychological stress
title Perceived Subjective Stress and its Association with 5-min Electrocardiogram-based Heart Rate Variability in Middle-aged Women of an Urban Area of West India
title_full Perceived Subjective Stress and its Association with 5-min Electrocardiogram-based Heart Rate Variability in Middle-aged Women of an Urban Area of West India
title_fullStr Perceived Subjective Stress and its Association with 5-min Electrocardiogram-based Heart Rate Variability in Middle-aged Women of an Urban Area of West India
title_full_unstemmed Perceived Subjective Stress and its Association with 5-min Electrocardiogram-based Heart Rate Variability in Middle-aged Women of an Urban Area of West India
title_short Perceived Subjective Stress and its Association with 5-min Electrocardiogram-based Heart Rate Variability in Middle-aged Women of an Urban Area of West India
title_sort perceived subjective stress and its association with 5 min electrocardiogram based heart rate variability in middle aged women of an urban area of west india
topic autonomic
cardiac
menopause
middle-aged
psychological stress
url https://journals.lww.com/10.4103/jmh.jmh_207_24
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