Clinical study: exercise testing

Age-predicted maximal heart rate revisited

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Abstract

OBJECTIVES

We sought to determine a generalized equation for predicting maximal heart rate (HRmax) in healthy adults.

BACKGROUND

The age-predicted HRmaxequation (i.e., 220 − age) is commonly used as a basis for prescribing exercise programs, as a criterion for achieving maximal exertion and as a clinical guide during diagnostic exercise testing. Despite its importance and widespread use, the validity of the HRmaxequation has never been established in a sample that included a sufficient number of older adults.

METHODS

First, a meta-analytic approach was used to collect group mean HRmaxvalues from 351 studies involving 492 groups and 18,712 subjects. Subsequently, the new equation was cross-validated in a well-controlled, laboratory-based study in which HRmaxwas measured in 514 healthy subjects.

RESULTS

In the meta-analysis, HRmaxwas strongly related to age (r = −0.90), using the equation of 208 − 0.7 × age. The regression equation obtained in the laboratory-based study (209 − 0.7 × age) was virtually identical to that obtained from the meta-analysis. The regression line was not different between men and women, nor was it influenced by wide variations in habitual physical activity levels.

CONCLUSIONS

1) A regression equation to predict HRmaxis 208 − 0.7 × age in healthy adults. 2) HRmaxis predicted, to a large extent, by age alone and is independent of gender and habitual physical activity status. Our findings suggest that the currently used equation underestimates HRmaxin older adults. This would have the effect of underestimating the true level of physical stress imposed during exercise testing and the appropriate intensity of prescribed exercise programs.

Abbreviations

HRmax
maximal heart rate
V̇;-1qo2
minute oxygen consumption

This work was supported by National Institutes of Health (Bethesda, Maryland) awards AG-00847, AG-06537 and AG-13038.