Heart rate recovery, exercise capacity, and mortality risk in male veterans

Kokkinos, Peter; Myers, Jonathan; Doumas, Michael; Faselis, Charles; Pittaras, Andreas; Manolis, Athanasios; Kokkinos, John; Narayan, Puneet; Papademetriou, Vasilios; Fletcher, Ross D.

doi:10.1177/1741826711398432

Cited by 26 publications

(31 citation statements)

References 40 publications

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“…Still, few studies were carried out in order to understand the interaction between HRR measures, aerobic fitness and mortality. In a pioneering study, Kokkinos et al 33 , evaluating the association between HRR (1 st and 2 nd min of recovery), aerobic fitness and risk of mortality from all causes in a cohort of 5,974 men with a follow-up period of 6.2 years, showed that in individuals with low aerobic fitness and low HRR, the mortality risk was approximately seven times higher when compared to subjects with good aerobic fitness and high HRR. The authors emphasize that the aerobic fitness associated with HRR substantially affects mortality.…”

Section: Discussionmentioning

confidence: 99%

Efeitos da idade e da aptidão aeróbica na recuperação da frequência cardíaca em homens adultos

Trevizani

Benchimol-Barbosa

Nadal

2012

Arq. Bras. Cardiol.

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Section: Discussionmentioning

confidence: 99%

Efeitos da idade e da aptidão aeróbica na recuperação da frequência cardíaca em homens adultos

Trevizani

Benchimol-Barbosa

Nadal

2012

Arq. Bras. Cardiol.

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“…First, the methods of HRR 2 assessment have included using a passive recovery period, with the participants placed supine immediately after peak exercise, 14,21,23,25,26,43 immediately seated, 18,41,50,70 or standing for 2 minutes and then seated for several minutes. 44 The methods using an active cooldown recovery have included walking at 1.5 mph and at 2.5% grade for 2 minutes 15,17,20,42 or at a speed of 1 mph for 1 minute. 12 Second, HRR has been examined during a range of minutes into recovery.…”

Section: Discussionmentioning

confidence: 99%

“…9–29 Poor ANS control of the CVS system is a plausible mechanism underlying the factors associated with attenuated HRR and increased risk for cardiac events and mortality. The preponderance of HRR research has focused on apparently healthy individuals, 18,30 men, 13–16,20,21,29 or patients with heart failure (HF). 22,31–37 …”

mentioning

confidence: 99%

“…Evidence of sex differences in HRR is mixed with data suggesting no sex differentials between men and both healthy women and women with CHD 13,43,46 and with data indicating that HRR in women is lower than in men. 12,40 Comparisons across studies of both the antecedents and the consequences of HRR are challenging and result in few evidence-based recommendations for clinical practice 20 for healthy compared with diseased cohorts or for age-specific and sex-specific populations.…”

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confidence: 99%

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Improvements in Heart Rate Recovery Among Women After Cardiac Rehabilitation Completion

Beckie

Beckstead²,

Kip³

et al. 2014

Journal of Cardiovascular Nursing

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Background Heart rate recovery (HRR) after exercise cessation is thought to reflect the rate of reestablishment of parasympathetic tone. Relatively little research has focused on improved HRR in women after completing cardiac rehabilitation (CR) exercise training. Objective We examined the influence of exercise training on HRR in women completing a traditional CR program and in women completing a CR program tailored for women. Methods A 2-group randomized clinical trial compared HRR between 99 women completing a traditional 12-week CR program and 137 women completing a tailored CR program. Immediately upon completion of a symptom-limited graded exercise test, HRR was measured at 1 through 6 minutes. Results Compared with baseline, improvement in 1-minute HRR (HRR1) was similar (P = 0.777) between the tailored (mean [SD], 17.5 [11] to 19.1 [12]) and the traditional CR program (15.7 [9.0] to 16.9 [9.5]). The amount of change in the 2-minute HRR (HRR2) for the tailored (30 [13] to 32.8 [14.6]) and traditional programs (28.3 [12.8] to 31.2 [13.7]) also was not different (P = 0.391). Similar results were observed for HRR at 3 through 6 minutes. Given these comparable improvements of the 2 programs, in the full cohort, the factors independently predictive of post-CR HRR1, in rank order, were baseline HRR1 (part correlation, 0.35; P < 0.001); peak exercise capacity, estimated as metabolic equivalents (METs; 0.24, P < 0.001); anxiety (−0.17, P = 0.001); and age (−0.13, P = 0.016). The factors independently associated with post-CR HRR2 were baseline HRR2 (0.44, P < 0.001), peak METs (0.21, P < 0.001), and insulin use (−0.10, P = 0.041). Conclusions One to 6 minutes after exercise cessation, HRR was significantly improved among the women completing both CR programs. The modifiable factors positively associated with HRR1 included peak METs and lower anxiety, whereas HRR2 was associated with insulin administration and peak METs. Additional research on HRR after exercise training in women is warranted.

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“…Clinical exercise tolerance tests (ETTs) to quantitatively assess cardiorespiratory fitness (CRF) and heart rate recovery (HRR) post-exercise can improve risk stratification [3]–[5], but the expense of testing large populations [6], [7] and low primary care utilization rates in young adults [8] limits clinical efforts for early risk detection. Exercise field tests (EFTs) completed while wearing commercial heart rate monitors (HRMs) may provide an inexpensive alternative for risk assessment in large populations, but improved CRF prediction models and validation of HRR measures are needed.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of an Exercise Field Test Using Heart Rate Monitors to Assess Cardiorespiratory Fitness and Heart Rate Recovery in an Asymptomatic Population

et al. 2014

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PurposeMeasures of cardiorespiratory fitness (CRF) and heart rate recovery (HRR) can improve risk stratification for cardiovascular disease, but these measurements are rarely made in asymptomatic individuals due to cost. An exercise field test (EFT) to assess CRF and HRR would be an inexpensive method for cardiovascular disease risk assessment in large populations. This study assessed 1) the predictive accuracy of a 12-minute run/walk EFT for estimating CRF () and 2) the accuracy of HRR measured after an EFT using a heart rate monitor (HRM) in an asymptomatic population.MethodsFifty subjects (48% women) ages 18–45 years completed a symptom-limited exercise tolerance test (ETT) (Bruce protocol) and an EFT on separate days. During the ETT, was measured by a metabolic cart, and heart rate was measured continuously by a HRM and a metabolic cart.ResultsEFT distance and sex independently predicted. The average absolute difference between observed and predicted was 0.26±3.27 ml·kg−1·min−1 for our model compared to 7.55±3.64 ml·kg−1·min−1 for the Cooper model. HRM HRR data were equivalent to respective metabolic cart values during the ETT. HRR at 1 minute post-exercise during ETT compared to the EFT had a moderate correlation (r = 0.75, p<0.001).ConclusionA more accurate model to estimate CRF from a 12-minute run/walk EFT was developed, and HRR can be measured using a HRM in an asymptomatic population outside of clinical settings.

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Heart rate recovery, exercise capacity, and mortality risk in male veterans

Abstract: HRR at 2 min post exercise is strongly and inversely associated with all-cause mortality. Exercise capacity affects HRR-associated mortality substantially and should be considered when applying HRR to estimate mortality.

Cited by 26 publications

References 40 publications

Efeitos da idade e da aptidão aeróbica na recuperação da frequência cardíaca em homens adultos

Efeitos da idade e da aptidão aeróbica na recuperação da frequência cardíaca em homens adultos

Improvements in Heart Rate Recovery Among Women After Cardiac Rehabilitation Completion

Evaluation of an Exercise Field Test Using Heart Rate Monitors to Assess Cardiorespiratory Fitness and Heart Rate Recovery in an Asymptomatic Population

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