SEX DIFFERENCES IN EXERCISE PRESCRIPTION USING MAXIMAL HEART RATE RESERVE IN MIDDLE AGE HEALTHY ADULTS

Thirty-eight children (mean age 12.2 ±3.6 yrs) were tested to (a) compare the training heart rate (HR) and oxygen uptake (V̇O2) computed from commonly used exercise prescription methods to the heart rate (HRAT) and V̇O2 (ATge) at the gas exchange anaerobic threshold, (b) compute the range of relative HRs and V̇O2s (% HRmax and % V̇O2max, respectively) at which the ATge occurred, and (c) discuss the implications for prescribing exercise intensity. The ATge occurred at a V̇O2 of 20.9 ml · kg−1 · min−1 and an HR of 129 beats·min−1. The training HR and V̇O2 computed using 70 and 85% HRmax, 70% of the maximal heart rate reserve (HRR), and 57 and 78% V·O2max, were significantly different (p<.05) from their corresponding ATge values. To compute training % HRmax, % V̇O2max, and % HRR values that would not significantly differ from the ATge, then 68% HRmax, 48% V̇O2max, and 41% HRR would need to be used for the current population.

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Exercise chronotropic incompetence phenotypes the level of cardiovascular risk and exercise gas exchange impairment in the general population. An analysis of the Euro-EX prevention trial

European Journal of Preventive Cardiology ◽

10.1177/2047487319863506 ◽

2019 ◽

Vol 27 (5) ◽

pp. 526-535 ◽

Cited By ~ 2

Author(s):

Pietro Laforgia ◽

Francesco Bandera ◽

Eleonora Alfonzetti ◽

Marco Guazzi

Keyword(s):

Heart Rate ◽

Cardiovascular Risk ◽

Gas Exchange ◽

Left Ventricular ◽

Prevention Trial ◽

Volume Index ◽

Maximal Heart Rate ◽

Heart Rate Reserve ◽

Peak Heart Rate ◽

Apparently Healthy

Background Chronotropic insufficiency (CI) is defined as the inability of the heart to increase its rate commensurate with increased demand. Exercise CI is an established predictor of major adverse cardiovascular events in patients with cardiovascular diseases. Aim The aim of this study was to evaluate how exercise CI phenotypes different levels of cardiovascular risk and how it may better perform in defining cardiovascular risk when analysed in the context of cardiopulmonary exercise test (CPET)-derived measures and standard echocardiography in a healthy population with variable cardiovascular risk profile. Methods Apparently healthy individuals ( N = 702, 53.8% females) with at least one major cardiovascular risk factor (MCVRF; hypertension, diabetes, tabagism, dyslipidaemia, body mass index > 25), enrolled in the Euro-EX prevention trial, underwent CPET. CI was defined as the inability to reach 80% of the chronotropic index, that is, the ratio of peak heart rate – rest heart rate/peak heart rate – age predicted maximal heart rate (AMPHR: 220 – age), they were divided into four groups according to the heart rate reserve (<80%>) and respiratory gas exchange ratio (RER; < 1.05>) as a marker of achieved maximal performance. Subjects with a RER < 1.05 ( n = 103) were excluded and the final population ( n = 599) was divided into CI group ( n = 472) and no-CI group ( n = 177). Results Compared with no-CI, CI subjects were more frequently females with a history of hypertension in a high rate. CI subjects also exhibited a significantly lower peak oxygen uptake (VO2) and circulatory power and an echocardiographic pattern indicative of higher left atrial volume index and left ventricular mass index. An inverse stepwise relationship between heart rate reserve and number of MCVRFs was observed (one MCVRF: 0.71 ± 0.23; two MCVRFs: 0.68 ± 0.24, three MCVRFs: 0.64 ± 0.20; four MCVRFs: 0.64 ± 0.23; five MCVRFs: 0.57 ± 18; p < 0.01). In multivariate analysis the only variable found predicting CI was peak VO2 ( p < 0.05; odds ratio 0.91; confidence interval 0.85–0.97). Conclusions In a population of apparently healthy subjects, exercise CI is common and phenotypes the progressive level of cardiovascular risk by a tight relationship with MCVRFs. CI patients exhibit some peculiar abnormal exercise gas exchange patterns (lower peak VO2 and exercise oscillatory ventilation) and echo-derived measures (higher left atrium size and left ventricle mass) that may well anticipate evolution toward heart failure.

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Methodological and practical application issues in exercise prescription using the heart rate reserve and oxygen uptake reserve methods

Journal of Science and Medicine in Sport ◽

10.1016/j.jsams.2010.07.008 ◽

2011 ◽

Vol 14 (1) ◽

pp. 46-57 ◽

Cited By ~ 36

Author(s):

Felipe Amorim da Cunha ◽

Paulo de Tarso Veras Farinatti ◽

Adrian W. Midgley

Keyword(s):

Heart Rate ◽

Oxygen Uptake ◽

Exercise Prescription ◽

Heart Rate Reserve ◽

Practical Application

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Abstract P319: Association of Heart Rate Reserve with Incidence of Hypertension in Men

Circulation ◽

10.1161/circ.127.suppl_12.ap319 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Vivek K Prasad ◽

Gregory A Hand ◽

Mei Sui ◽

Duck C Lee ◽

Deepika Shrestha ◽

...

Keyword(s):

Heart Rate ◽

Exercise Test ◽

Heavy Drinking ◽

Risk Groups ◽

Hazard Ratio ◽

Maximal Heart Rate ◽

Heart Rate Reserve ◽

Incident Hypertension ◽

The Difference ◽

Design And Methods

Abstract Objectives— We examined the association between heart rate reserve (HRR) and incident hypertension in men in the Aerobics Center Longitudinal Study. Research design and Methods— A total of 10418 healthy normotensive men, who did not have an abnormal electrocardiogram or a history of heart attack, stroke, cancer, or diabetes, performed a maximal treadmill exercise test and were followed for the incidence of hypertension. HRR was defined as the difference between maximal heart rate during exercise test and resting heart rate. Results— During a mean follow-up of 6 years, there were 2831 cases of incident hypertension. Compared with men in the reference category (the lowest quartile of HRR), the risk of incident hypertension was significantly lower in the highest quartile of HRR with a hazard ratio 0.67 (95% CI: 0.60-0.75) when adjusted for age and baseline examination year. Further adjustment for smoking, heavy drinking, body mass index (BMI), resting systolic and diastolic blood pressure, cholesterol, blood glucose and cardio respiratory fitness, resulted a hazard ratio of 0.84 (95% CI:0.74-0.95). This result was almost similar when we stratified them into younger and older men with hazard ratio of 0.77(95% CI: 0.62-0.98) and 0.78 (95% CI: 0.66-0.90) respectively. We also found a significant lower hypertension risk associated with higher HRR among high risk groups such as overweight, low fitness, or prehypertension with hazard ratio of 0.82(95% CI:0.70-0.97), 0.80(95% CI:0.67-0.96), 0.76(95% CI:0.64-0.88) respectively. Conclusion— Risk of Incident hypertension was significantly lower in men with higher HRR. High HRR was also associated with lower risk of developing hypertension irrespective of age and status of risk factors such as high BMI, low fitness and prehypertension. Therefore, HRR may be considered as a reliable exercise parameter for predicting the risk of incident hypertension.

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