European Heart Journal Advance Access published online on January 6, 2006
European Heart Journal, doi:10.1093/eurheartj/ehi708
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1 Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, 70100 Kuopio, Finland
* To whom correspondence should be addressed. Aims The objective is to study whether a heart rate (HR) response during exercise test independently predicts cardiovascular disease (CVD) mortality. Methods and 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 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. Conclusion 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.
Received April 2, 2005
Revised November 15, 2005
Accepted December 8, 2005
Clinical research
Heart rate response during exercise test and cardiovascular mortality in middle-aged men
Kai P. Savonen 1,
Timo A. Lakka 2,
Jari A. Laukkanen 3,
Pirjo M. Halonen 4,
Tuomas H. Rauramaa 1,
Jukka T. Salonen 5,
and
Rainer Rauramaa 6 *
2 Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, 70100 Kuopio, Finland; Department of Physiology, University of Kuopio, Kuopio, Finland; Pennington Biomedical Research Center, Baton Rouge, LA, USA
3 Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, 70100 Kuopio, Finland; Research Institute of Public Health, University of Kuopio, Kuopio, Finland
4 IT Service Centre, University of Kuopio, Kuopio, Finland
5 Research Institute of Public Health, University of Kuopio, Kuopio, Finland; Department of Community Health and General Practise, University of Kuopio, Kuopio, Finland; Inner Savo Health Centre, Suonenjoki, Finland; Oy Jurilab Ltd, Kuopio, Finland
6 Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, 70100 Kuopio, Finland; Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
Rainer Rauramaa, E-mail: rainer.rauramaa{at}messi.uku.fi
Abstract 
-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.
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