Key result
HRmax prediction models lack precision versus CPET in endurance athletes.
Why the study?
Prediction of HRmax is an alternative to CPET, but its accuracy among endurance athletes required external evaluation for running and cycling.
Do HRmax prediction models accurately estimate maximal heart rate compared to CPET in endurance athletes?
Cross-Sectional (n=5,069)
Do HRmax prediction models accurately estimate maximal heart rate compared to CPET in endurance athletes?
Effect estimate: RMSE 9.1-10.5
p-value: p=0.001
HRmax prediction models have limited precision and often underestimate HRmax in endurance athletes, making CPET the preferred method for accurate assessment.
Clinicians should not yet change practice based on HRmax prediction models in endurance athletes; cross-sectional data leaves open prospective validation.
Maximal heart rate (HRmax) is a widely used measure of cardiorespiratory fitness. Prediction of HRmax is an alternative to cardiopulmonary exercise testing (CPET), but its accuracy among endurance athletes (EA) requires evaluation. This study aimed to externally validate HRmax prediction models in the EA independently for running and cycling CPET. A total of 4043 runners (age = 33.6 (8.1) years; 83.5% males; BMI = 23.7 (2.5) kg·m−2) and 1026 cyclists (age = 36.9 (9.0) years; 89.7% males; BMI = 24.0 (2.7) kg·m−2) underwent maximum CPET. Student t-test, mean absolute percentage error (MAPE), and root mean square error (RMSE) were applied to validate eight running and five cycling HRmax equations externally. HRmax was 184.6 (9.8) beats·min−1 and 182.7 (10.3) beats·min−1, respectively, for running and cycling, p = 0.001. Measured and predicted HRmax differed significantly (p = 0.001) for 9 of 13 (69.2%) models. HRmax was overestimated by eight (61.5%) and underestimated by five (38.5%) formulae. Overestimated HRmax amounted to 4.9 beats·min−1 and underestimated HRmax was in the range up to 4.9 beats·min−1. RMSE was 9.1–10.5. MAPE ranged to 4.7%. Prediction models allow for limited precision of HRmax estimation and present inaccuracies. HRmax was more often underestimated than overestimated. Predicted HRmax can be implemented for EA as a supplemental method, but CPET is the preferable method.
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Kasiak et al. (2023) conducted a cross-sectional in Endurance athletes (runners and cyclists) (n=5,069). HRmax prediction models vs. Cardiopulmonary exercise testing (CPET) was evaluated on Difference between measured and predicted HRmax (RMSE 9.1-10.5, p=0.001). Maximal heart rate prediction models showed limited precision compared to cardiopulmonary exercise testing in endurance athletes, with 9 of 13 models differing significantly from measured values (p=0.001).
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