Key result
Abnormal heart rate recovery is linked to ~3.2-fold higher 72-month mortality.
Why the study?
The study aimed to investigate whether heart rate recovery is a predictor of all-cause mortality in a 72-month survival analysis.
Does abnormal heart rate recovery predict all-cause mortality over 72 months in a high-risk cardiovascular cohort?
Cohort (n=578)
No
Does abnormal heart rate recovery predict all-cause mortality over 72 months in a high-risk cardiovascular cohort?
Hazard Ratio: 3.16 (95% CI 1.86–5.35)
Absolute Event Rate: 81.6% vs 93.8%
p-value: p=<0.001
Abnormal heart rate recovery at 1 minute post-exercise is a simple, non-invasive indicator of autonomic dysfunction that strongly predicts long-term all-cause mortality in high-risk cardiovascular patients.
Abnormal post-exercise HRR signals higher mortality risk in exercise testing; leaves open its independent prognostic value beyond comorbidities.
This study aimed to investigate whether heart rate recovery (HRR) is a predictor of all-cause mortality in a 72-month survival analysis. In this cohort study, 578 individuals who underwent a maximal exercise test at a university hospital between August 2012 and August 2018 were followed for up to 72 months. Participants performed a maximal incremental treadmill test, followed by an active recovery period phase to evaluate their HRR. When the decay of heart rate totaled ≥ 13bpm in the first minute post-exercise a normal HRR was considered, whereas an abnormal HRR was defined as ≤ 12bpm. Of the 578 individuals, 371 (64.2%) had normal HRR, whereas 207 (35.8%) had an abnormal HRR. The survival analysis showed significantly higher 72-month survival in the normal HRR group (93.8%) than in the abnormal HRR group (81.6%), with a 3.16 hazard ratio (95%CI: 1.86-5.35). Individuals with abnormal HRR were generally older, had a greater burden of comorbidities, shorter time to exhaustion, lower peak heart rate, and higher heart rate 60 seconds after the exercise. Thus, HRR predicted 72-month all-cause mortality. These findings suggest the use of HRR as a simple, non-invasive prognostic tool in clinical practice, particularly for stratifying mortality risk.
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Costa et al. (2026) conducted a cohort in High cardiovascular risk (n=578). Abnormal heart rate recovery (≤ 12 bpm) vs. Normal heart rate recovery (≥ 13 bpm) was evaluated on 72-month all-cause mortality (reported as survival) (HR 3.16, 95% CI 1.86-5.35, p=<0.001). Abnormal heart rate recovery (≤ 12 bpm) post-exercise was associated with a significantly lower 72-month survival rate compared to normal recovery (81.6% vs 93.8%; HR 3.16).
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