title: Heart rate response during exercise test and cardiovascular mortality in middle-aged men.
abstract: OBJECTIVE
  The objective is to study whether a heart rate (HR) response during exercise test independently predicts cardiovascular disease (CVD) mortality.
  
  
  RESULTS
  The subjects were a representative sample of 1378 men, 42-61 years of age, from eastern Finland with neither prior coronary heart disease (CHD) nor use of beta-blockers at baseline. HR was measured at rest and during a maximal, symptom-limited exercise test at 20, 40, 60, 80, and 100% of maximal workload. During an average follow-up of 11.4 years, there were 56 deaths due to CVD. The slope of HR increase during exercise test was steeper in survivors when compared with those who died due to CVD during follow-up (P<0.001), and the difference in the steepness of HR slope between the groups was the strongest at interval 40-100% (P<0.001). In Cox-multivariable models, maximal HR-HR at 40% workload as a continuous variable was inversely associated with CVD (P=0.04), CHD (P=0.004), and all-cause (P=0.002) mortality after adjustment for known risk factors for CVD death.
  
  
  CONCLUSIONS
  By considering an HR response throughout an exercise test, we found that a blunted HR increase at 40-100% of maximal workload was associated with increased CVD mortality.
authors.affiliation: Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, 70100 Kuopio, Finland.
authors.forename: Kai P
authors.initials: KP
authors.lastname: Savonen
authors.forename: Timo A
authors.initials: TA
authors.lastname: Lakka
authors.forename: Jari A
authors.initials: JA
authors.lastname: Laukkanen
authors.forename: Pirjo M
authors.initials: PM
authors.lastname: Halonen
authors.forename: Tuomas H
authors.initials: TH
authors.lastname: Rauramaa
authors.forename: Jukka T
authors.initials: JT
authors.lastname: Salonen
authors.forename: Rainer
authors.initials: R
authors.lastname: Rauramaa
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000503:physiopathology; D002423:Cause of Death; D004562:Electrocardiography; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors