title: Delayed heart rate recovery is strongly associated with early and late-stage prehypertension during exercise stress testing.
abstract: BACKGROUND
  Heart rate recovery (HRR) has been shown to predict cardiovascular disease mortality. HRR is delayed in hypertension, but its association with prehypertension (PHT) has not been well studied.
  
  
  METHODS
  The study population consisted of 683 asymptomatic individuals (90% men, aged 47±7.9 years). HRR was defined as peak heart rate minus heart rate after a 2-minute rest. PHT was categorized into stage I (systolic blood pressure (SBP) 120-129mm Hg or diastolic BP (DBP) 80-84mm Hg) or stage II (SBP 130-139mm Hg or DBP 85-89mm Hg). Logistic regression was used to generate odds ratios (ORs) for the relationship between HRR and PHT.
  
  
  RESULTS
  The mean HRR was lower in the PHT groups than in those who were normotensive (60 bpm and 58 bpm in stages I and II PHT vs. 65 bpm in normal BP; P <0.01). Persons with PHT were more likely to be in the lowest quartile of HRR compared with those with normal BP (adjusted OR, 3.80 and 95% confidence interval [CI], 1.06, 13.56 for stage II PHT and adjusted OR, 3.01 and 95% CI 1.05, 8.66 for stage I PHT). In a fully adjusted model, HRR was still significantly associated with both stages of PHT.
  
  
  CONCLUSIONS
  Among asymptomatic patients undergoing stress testing, delayed HRR was independently associated with early and late stages of PHT. Further studies are needed to determine the usefulness of measuring HRR in the prevention and management of hypertension.
authors.affiliation: Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, Florida.
authors.forename: Ehimen
authors.initials: E
authors.lastname: Aneni
authors.forename: Lara L
authors.initials: LL
authors.lastname: Roberson
authors.forename: Sameer
authors.initials: S
authors.lastname: Shaharyar
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Blaha
authors.forename: Arthur A
authors.initials: AA
authors.lastname: Agatston
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
authors.forename: Romeu S
authors.initials: RS
authors.lastname: Meneghelo
authors.forename: Raquel D
authors.initials: RD
authors.lastname: Conceiçao
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
authors.forename: Raul D
authors.initials: RD
authors.lastname: Santos
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058246:Prehypertension / Q000453:epidemiology / Q000503:physiopathology*
keywords: blood pressure; cardiac autonomic function; heart rate recovery; hypertension; prehypertension.