Delayed heart rate recovery after exercise predicts development of metabolic syndrome: A retrospective cohort study

• Published in: Journal of diabetes investigation Vol. 13; no. 1; pp. 167 - 176
• Main Authors: Yu, Tae Yang, Hong, Won‐Jung, Jin, Sang‐Man, Hur, Kyu Yeon, Jee, Jae Hwan, Bae, Ji Cheol, Kim, Jae Hyeon, Lee, Moon‐Kyu
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01-01-2022; John Wiley and Sons Inc; Wiley
• Subjects: Beta blockers; Cardiometabolic Risk Factors; Cardiovascular disease; Cardiovascular diseases; Cohort analysis; Cross-sectional studies; Diabetes; Diabetes mellitus; Exercise - physiology; Exercise Test; Female; Fitness equipment; Heart Rate; Heart rate recovery; High density lipoprotein; Humans; Hypertension; Incidence; Incident metabolic syndrome; Longitudinal cohort study; Longitudinal Studies; Male; Metabolic syndrome; Metabolic Syndrome - epidemiology; Metabolic Syndrome - etiology; Middle Aged; Obesity; Original; Physical training; Predictive Value of Tests; Proportional Hazards Models; Recovery of Function - physiology; Rest - physiology; Retrospective Studies; Risk factors; Statistical analysis; Variables; Womens health; Incident metabolic syndrome; Longitudinal cohort study; Heart rate recovery
• ISSN: 2040-1116; 2040-1124
• DOI: 10.1111/jdi.13637

ABSTRACT
Aims/Introduction
Several cross‐sectional studies have shown that delayed heart rate recovery (HRR) after exercise is associated with the development of metabolic syndrome (MetS). However, there has been a lack of comprehensively designed longitudinal studies. Therefore, our aim was to evaluate the longitudinal association of delayed HRR following a graded exercise treadmill test (GTX) with incident MetS.
Materials and Methods
This was a retrospective longitudinal cohort study of participants without MetS, diabetes, or cardiovascular diseases. The HRR was calculated as the peak heart rate minus the resting heart rate after a 1 min rest (HRR1), a 2 min rest (HRR2), and a 3 min rest (HRR3). Multivariate Cox proportional hazards analysis was performed to investigate the association between HRR and development of MetS.
Results
There were 676 (31.2%) incident cases of MetS identified during the follow‐up period (9,683 person‐years). The only statistically significant relationship was between HRR3 and the development of MetS. The hazard ratios (HRs) (95% confidence interval [CI]) of incident MetS comparing the first and second tertiles to the third tertile of HRR3 were 1.492 (1.146–1.943) and 1.277 (1.004–1.624) with P = 0.003 after adjustment for multiple risk factors. As a continuous variable, the HR (95% CI) of incident MetS associated with each one‐beat decrease in HRR3 was 1.015 (1.005–1.026) with P = 0.004 after full adjustments. An HRR3 value ≤45 beats per minute (bpm) was associated with a higher risk of incident MetS compared with values >45 bpm, with an HR (95% CI) of 1.304 (1.061–1.602) and P = 0.001.
Conclusions
The slow phase of HRR, particularly HRR3, might be more sensitive at predicting the risk of MetS.
Delayed HRR3 after exercise could predict incident MetS in a general population, even after adjusting for fasting plasma glucose, HOMA‐IR, and HbA1c. And a HRR3 value of 45 beats per minute (bpm) or below was associated with a significantly higher risk of incident MetS compared with values over 45 bpm.