Delayed Heart Rate Recovery is Strongly Associated With Early and Late-Stage Prehypertension During Exercise Stress Testing

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) 120-129 mm Hg or diastolic BP (DBP) 80-84 mm Hg) or stage II (SBP 130-139 mm Hg or DBP 85-89 mm 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. CONCLUSION 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.