Chronotropic Incompetence May Up Death Risk in Women

However, male-based calculation overestimates the peak heart rate for age in women

MONDAY, June 28 (HealthDay News) -- An attenuated heart rate response -- or chronotropic incompetence -- to exercise stress testing is linked to an increased risk of mortality in asymptomatic women, but the traditional calculation -- based on data from males -- overestimates women's maximum heart rate for age, according to a study published online June 28 in Circulation.

Martha Gulati, M.D., of Northwestern University in Evanston, Ill., and colleagues evaluated 5,437 asymptomatic women to determine the association between heart rate response to exercise testing and age. The authors point out that studies describing a normative response to exercise stress testing have been based predominantly on data from males.

Mean peak heart rate in the study subjects was found to have an inverse association with age. After adjusting for exercise capacity and cardiovascular risk factors, the researchers found that mortality risk was reduced by 3 percent for every one-beat-per-minute increase in peak heart rate, with mortality risk decreasing by 2 percent for every one-beat-per-minute increase in heart rate reserve. While the inability to achieve 85 percent age-predicted heart rate was not an independent predictor of mortality, being at least one standard deviation below the mean predicted heart rate or a chronotropic index less than 0.80 based on the prediction model generated by this group were independent predictors of mortality.

"Chronotropic incompetence is associated with an increased risk of death in asymptomatic women; however, the traditional male-based calculation overestimates the maximum heart rate for age in women," the authors write. "Sex-specific parameters of physiological heart rate response to exercise should be incorporated into clinical practice."

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Beth Gilbert

Beth Gilbert

Updated on June 28, 2010

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