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Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
SUMMARIES FOR PATIENTS
Heart Rate Recovery after Submaximal Exercise Testing as a Predictor of Mortality in a Cardiovascularly Healthy Cohort
4 April 2000 | Volume 132 Issue 7 | Page 552
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians-American Society of Internal Medicine.
The summary below is from the full report titled "Heart Rate Recovery after Submaximal Exercise Testing as a Predictor of Mortality in a Cardiovascularly Healthy Cohort.". It is in the 4 April 2000 issue of Annals of Internal Medicine (volume 132, pages 552-555). The authors are C.R. Cole, J.M. Foody, E.H. Blackstone, and M.S. Lauer.
What is the problem and what is known about it so far?
Researchers have shown that the time it takes for the heart rate to return to normal after exercise (heart rate recovery) is associated with a person's risk for death. The longer it takes for the heart rate to return to normal, the greater the risk for death. This relation has been demonstrated only in people with known cardiovascular disease. It is unknown, however, whether the same relation between heart rate recovery and risk for death exists in healthy people.
Why did the researchers do this particular study?
The researchers wanted to find out whether, in healthy adults, the time it takes for heart rate to return to normal after exercise is associated with the risk for death.
Who was studied?
The researchers studied 5234 adults who had no known cardiovascular disease and were participating in a large study of the frequency of high cholesterol levels in people who live in North America.
How was the study done?
The researchers had each person in the study exercise on a treadmill according to a standard protocol. The researchers had the people exercise until they reached 85% to 90% of the predicted maximum heart rate for a person their age. They then recorded the fastest heart rate that the patient had during this exercise and the heart rate 2 minutes later. Heart rate recovery was the difference between these two heart rates. If the heart rate did not slow by at least 42 beats per minute during this 2-minute period, the person was considered to have abnormal heart rate recovery. The researchers then followed patients for an average of 12 years to see who died.
What did the researchers find?
Even after accounting for other risk factors for death, people who had abnormal heart rate recovery were still 1.5 times more likely to die than people who had normal heart rate recovery.
What were the limitations of the study?
This study does not explain why heart rate recovery is associated with the risk for death. It also does not tell us whether improving heart rate recovery by fitness training or some other means would decrease a person's risk of death.
What are the implications of the study?
Heart rate recovery is a relatively simple measure that can help predict the risk for death. It may make sense to include this measure into the routine interpretation of exercise tests.
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