Heart Rate Recovery after Submaximal Exercise Testing as a Predictor of Mortality in a Cardiovascularly Healthy Cohort

Abstract

Abnormal heart rate recovery after symptom-limited exercise predicts death. It is unknown whether this is also true among patients undergoing submaximal testing. To test the prognostic implications of heart rate recovery in cardiovascularly healthy adults undergoing submaximal exercise testing. Population-based cohort study. 10 primary care sites. 5234 adults without evidence of cardiovascular disease who were enrolled in the Lipid Research Clinics Prevalence Study. Heart rate recovery was defined as the change from peak heart rate to that measured 2 minutes later (heart rate recovery was defined as ≤ 42 beats/min). 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). Even after submaximal exercise, abnormal heart rate recovery predicts death.