Slow heart rate recovery after exercise is associated with carotid atherosclerosis.
OBJECTIVE
Slow heart rate recovery (HRR) after exercise is an estimate of impaired parasympathetic tone and predictor of all-cause and cardiovascular mortality. Carotid atherosclerosis is associated with high risk of developing coronary heart disease (CHD) and stroke. We tested the hypothesis that slow HRR is associated with carotid atherosclerosis in a cross-sectional study of 12,712 middle-aged men (age 49.1+/-8.9 years).


METHODS
Carotid atherosclerosis was measured using B-mode ultrasonography and defined as stenosis >25% and/or intima-media thickness >1.2mm. HRR was calculated as the difference between peak heart rate during a graded exercise treadmill test and heart rate 2 min after cessation of exercise.


RESULTS
The prevalence of carotid atherosclerosis was 8.4%. The prevalence of atherosclerosis was significantly higher among subjects in the lowest (<44 bpm) versus the highest (>61 bpm) quartile of HRR (14.4% versus 4.1%, p<0.001). In multivariable logistic regression models adjusted for established CHD risk factors, inflammatory markers, and exercise capacity, subjects in the lowest quartile of HRR (<44 bpm) were 1.50 times (95% CI: 1.13-2.00) more likely to have carotid atherosclerosis than subjects in the highest quartile (HRR>61 bpm).


CONCLUSIONS
Slow heart rate recovery after exercise, an index of decreased parasympathetic activity, is associated with carotid atherosclerosis independent of established risk factors in middle-age men.
Jae
Sae Young
SY
Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, 112 Huff Hall, MC-586, 1206 S. Fourth Street, Champaign, IL 61820, United States.
Carnethon
Mercedes R
MR
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
Heffernan
Kevin S
KS
Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, 112 Huff Hall, MC-586, 1206 S. Fourth Street, Champaign, IL 61820, United States.
Choi
Yoon-Ho
YH
Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Lee
Moon-Kyu
MK
Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Park
Won Hah
WH
Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Fernhall
Bo
B
Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, 112 Huff Hall, MC-586, 1206 S. Fourth Street, Champaign, IL 61820, United States. Electronic address: fernhall@uiuc.edu.
D000328:Adult; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography