Heart rate recovery after submaximal exercise testing as a predictor of mortality in a cardiovascularly healthy cohort

Abstract

Background: Abnormal heart rate recovery after symptom-limited exercise predicts death. It is unknown whether this is also true among patients undergoing submaximal testing.

Objective: To test the prognostic implications of heart rate recovery in cardiovascularly healthy adults undergoing submaximal exercise testing.

Design: Population-based cohort study.

Setting: 10 primary care sites.

Participants: 5234 adults without evidence of cardiovascular disease who were enrolled in the Lipid Research Clinics Prevalence Study.

Measurements: Heart rate recovery was defined as the change from peak heart rate to that measured 2 minutes later (heart rate recovery was defined as < or =42 beats/min).

Results: During 12 years of follow-up, 312 participants died. Abnormal heart rate recovery predicted death (relative risk, 2.58 [CI, 2.06 to 3.20]). After adjustment for standard risk factors, fitness, and resting and exercise heart rates, abnormal heart rate recovery remained predictive (adjusted relative risk, 1.55 [CI, 1.22 to 1.98]) (P<0.001).

Conclusion: Even after submaximal exercise, abnormal heart rate recovery predicts death.