Prognostic Performance of Heart Rate Recovery on an Exercise Test in a Primary Prevention Population
Open accessAbstract
Background: Heart rate ( HR ) recovery has been investigated in specific patient cohorts, but there is less information about the role of HR recovery in general populations. We investigated whether HR recovery has long‐term prognostic significance in primary prevention. Methods and Results: Exercise tests performed between 1993 and 2010 on patients aged 30 to 79 years without cardiovascular disease were included. Mortality was determined from Mayo Clinic records and Minnesota Death Index. Total, cardiovascular , and non‐cardiovascular mortality was reported according to HR recovery <13 bpm using Cox regression. 19 551 patients were included, 6756 women (35%), age 51±10 years. There were 1271 deaths over follow‐up of 12±5 years. HR recovery declined after age 60, and was also lower according to diabetes mellitus, hypertension, obesity, current smoking, and poor cardiorespiratory fitness but not sex or β‐blockers. Adjusting for these factors, abnormal HR recovery was a significant predictor of total (hazard ratio [95% confidence interval]=1.56 [1.384–1.77]), cardiovascular (1.95 [1.57–2.42]), and non‐cardiovascular death (1.41 [1.22–1.64]). Hazard ratios for cardiovascular death according to abnormal HR recovery were significant in all age groups (30–59, 60–69, 70–79), in both sexes, in patients with and without hypertension, obesity, and diabetes mellitus, but not in patients taking β‐blockers, current smokers, and patients with normal cardiorespiratory fitness. Conclusions: HR recovery is a powerful prognostic factor predicting total, cardiovascular, and non‐cardiovascular death in a primary prevention cohort. It performs consistently well according to sex, age, obesity, hypertension, and diabetes mellitus but shows diminished utility in patients taking β‐blockers, current smokers, and patients with normal cardiorespiratory fitness.
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Impaired heart rate recovery after exercise correlates with increased adverse cardiovascular events.
“An impaired HR recovery after exercise correlates with increased adverse cardiovascular events14.”
From Smart wearable devices in cardiovascular care: Where we are and how to move forward (2021) · cites this paper as [14]
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Smart wearable devices in cardiovascular care: Where we are and how to move forward
Bayoumy, K., Gaber, M., Elshafeey, A., Mhaimeed, O., Dineen, E. H., Marvel, F. A., Martin, S. S., Muse, E. D., Turakhia, M. P., Tarakji, K. G., et al. (2021) · Nature Reviews Cardiology · doi:10.1038/s41569-021-00522-7 · Cited by 829 · see citing works
- Authors
- Sydó, N., Sydó, T., Gonzalez Carta, K. A., Hussain, N., Farooq, S., Murphy, J. G., Merkely, B., Lopez‐Jimenez, F., & Allison, T. G.
- Affiliations
- Semmelweis University (HU)
- Csolnoky Ferenc Hospital, Veszprém, Hungary
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
- Mayo Clinic (US)
- Corresponding author
- Sydó, Nóra
- Sydó, Tibor
- Allison, Thomas G.
- Venue
- Journal of the American Heart Association
- Published
- 2018-04-03
- Volume
- 7
- Issue
- 7
- ISSN
- 2047-9980 (ISSN-L)
- PMC
- PMC5907593
- OpenAlex
- W2794280299
- Cited by
- 45
- References
- 35
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 6 · 2023: 5 · 2022: 4 · 2021: 12 · 2020: 3 · 2019: 6 · 2018: 2
- FWCI
- 7.89
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- Journal of the American Heart Association (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Semmelweis University Repository (Semmelweis University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart rate and cardiovascular health
- Keywords
- heart rate recovery, exercise testing, primary prevention, cardiovascular mortality, all-cause mortality, prognostic factors, autonomic function, beta-blockers, cardiorespiratory fitness, smoking, hypertension, diabetes mellitus, obesity
- MeSH terms
- Cardiorespiratory Fitness, Adult, Aged, Cardiovascular Diseases, Cause of Death, Exercise Test, Female, Health Status, Heart Rate, Humans, Male, Middle Aged, Minnesota, Predictive Value of Tests, Primary Prevention, Prognosis, Retrospective Studies, Risk Factors, Time Factors, Risk Assessment, Recovery of Function
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