Heart rate response to a timed walk and cardiovascular outcomes in older adults: The cardiovascular health study

Saket Girotra, Dalane W. Kitzman, Willem J. Kop, Phyllis K. Stein, John S. Gottdiener, Kenneth J. Mukamal

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Objectives: To determine the relationship between heart rate response during low-grade physical exertion (6-min walk) with mortality and adverse cardiovascular outcomes in the elderly. Methods: Participants in the Cardiovascular Health Study who completed a 6-min walk test were included. We used delta heart rate (difference between postwalk heart rate and resting heart rate) as a measure of chronotropic response and examined its association with (1) all-cause mortality and (2) incident coronary heart disease event, using multivariable Cox regression models. Results: We included 2,224 participants (mean age 77 ± 4 years; 60% women; 85% white). The average delta heart rate was 26 beats/min. Participants in the lowest tertile of delta heart rate (<20 beats/min) had higher risk-adjusted mortality [hazard ratio (HR) 1.18, 95% confidence interval (CI) 1.00-1.40] and incident coronary heart disease (HR 1.37, 95% CI 1.05-1.78) compared to subjects in the highest tertile (≥30 beats/min), with a significant linear trend across tertiles (p for trend <0.05 for both outcomes). This relationship was not significant after adjustment for distance walked. Conclusion: Impaired chronotropic response during a 6-min walk test was associated with an increased risk of mortality and incident coronary heart disease among the elderly. This association was attenuated after adjusting for distance walked.

Original languageEnglish
Pages (from-to)69-75
Number of pages7
JournalCardiology (Switzerland)
Volume122
Issue number2
DOIs
StatePublished - Aug 1 2012

Keywords

  • Coronary heart disease
  • Elderly
  • Exercise
  • Heart rate

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