February 25, 2011European Journal of Preventive Cardiology
Heart rate recovery, exercise capacity, and mortality risk in male veterans
Key result
Heart rate recovery ≤14 beats/min at 2 minutes linked to ~140% higher all-cause mortality.
- HR 2.4
- 95% CI 1.6-3.5
- n=5,974
Why the study?
The interaction between heart rate recovery, mortality, and fitness has not been clearly defined.
Does impaired heart rate recovery combined with low exercise capacity predict higher all-cause mortality in male veterans?
Population
5974 male veterans undergoing treadmill exercise testing at two Veterans Affairs Medical Centers
Comparison
Low fitness and low HRR (≤6 METs and ≤14 beats/min) vs high fitness and high HRR (>6 METs and >14 beats/min)
Design
Cohort study
Follow-up
Mean 6.2 years
Authors
Discussion
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Implication
Fitness-adjusted HRR may refine mortality risk estimates in referred veterans; leaves open prospective validation and broader applicability.
Study Design
Type
Cohort (n=5,974)
Multicenter
Yes
Structured PICO
Does impaired heart rate recovery combined with low exercise capacity predict higher all-cause mortality in male veterans?
P
Population
5,974 male veterans undergoing clinical treadmill exercise testing, followed for a mean of 6.2 years.
E
Exposure
Assessment of heart rate recovery (HRR) at 1 and 2 minutes post-exercise and exercise capacity (fitness)
C
Comparator
High fitness (>6 metabolic equivalents) and high HRR (>14 beats/min at 2 min) group
O
Outcome
All-cause mortality over a mean 6.2-year follow-up periodhard clinical
Main Result
Hazard Ratio: 2.4 (95% CI 1.6–3.5)
Heart rate recovery at 2 minutes post-exercise is a strong predictor of all-cause mortality, but its prognostic value is substantially affected by baseline exercise capacity and both should be considered together.
Cite This Study
Kokkinos et al. (2011) conducted a cohort in Patients undergoing clinical exercise testing (n=5,974). Low heart rate recovery (≤14 beats/min at 2 min) and low fitness vs. High heart rate recovery (>14 beats/min) and high fitness was evaluated on All-cause mortality (HR 2.4, 95% CI 1.6-3.5). Heart rate recovery ≤14 beats/min at 2 minutes post-exercise predicted all-cause mortality (HR 2.4; 95% CI 1.6-3.5), with risk increasing seven-fold when combined with low fitness.