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Medical Forum / General / Cardiology / January 2006

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Recovery rate

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Javier - 19 Jan 2006 19:15 GMT
After a good one hour climbing interval session on my bike I took my
recovery heart rate via my HRM and I went from 126bpm to 81bpm in 2
minutes. Is this a good or bad recovery rate?

Javier
Don Kirkman - 19 Jan 2006 21:05 GMT
It seems to me I heard somewhere that Javier wrote in article
<1137698122.410675.37190@g14g2000cwa.googlegroups.com>:

>After a good one hour climbing interval session on my bike I took my
>recovery heart rate via my HRM and I went from 126bpm to 81bpm in 2
>minutes. Is this a good or bad recovery rate?

ISTM a drop of 45 beats in two minutes is very good.  Runners tend to
use a drop to a baseline rather than a numerical guideline, but
typically might expect a drop from 140/150 to about 110 in two
minutes--always subject to fitness level and the intensity and duration
of the particular workout.
Signature

Don Kirkman

Javier - 20 Jan 2006 01:08 GMT
Thanks Don, I tried to find a definitive answer on the web as to what
is considered a good drop but each site differed greatly. I'll see what
my recovery rate is during a time trial workout where I usually get my
heart rate up to 151 bpm. Not like climbing reapeats are not easy
either.
Don Kirkman - 20 Jan 2006 08:41 GMT
It seems to me I heard somewhere that Javier wrote in article
<1137719318.153718.125210@g47g2000cwa.googlegroups.com>:

>Thanks Don, I tried to find a definitive answer on the web as to what
>is considered a good drop but each site differed greatly. I'll see what
>my recovery rate is during a time trial workout where I usually get my
>heart rate up to 151 bpm. Not like climbing reapeats are not easy
>either.

I neglected to mention that there are two approaches to checking
recovery.  One is to time how long it takes to recover between two pulse
rates, for example a drop from 150 to 120; the other is what the drop is
during a set time (runners usually use two or three minutes, I think). I
think as a practical matter either one is okay.
Signature

Don Kirkman

Tony Wesley - 20 Jan 2006 04:12 GMT
> It seems to me I heard somewhere that Javier wrote in article
> <1137698122.410675.37190@g14g2000cwa.googlegroups.com>:
[quoted text clipped - 8 lines]
> minutes--always subject to fitness level and the intensity and duration
> of the particular workout.

I few years ago, I remember reading an article that claimed the
recovery rate was one of the best predictors of mortality.

I just went and googled and found it, in the New England Journal of
Medicine.

 http://content.nejm.org/cgi/content/full/341/18/1351

Heart-Rate Recovery Immediately after Exercise as a Predictor of
Mortality
Christopher R. Cole, M.D., Eugene H. Blackstone, M.D., Fredric J.
Pashkow, M.D., Claire E. Snader, M.A., and Michael S. Lauer, M.D.

>From the results:
"In univariate analyses, a low value for the recovery of heart rate
was strongly predictive of death (relative risk, 4.0; 95 percent
confidence interval, 3.0 to 5.2; P<0.001)."

There is an interview
 http://www.abc.net.au/rn/talks/8.30/helthrpt/stories/s63595.htm

In a six-year follow-up study, researchers showed that in a group of
men and women aged around 57, the heart rate one minute after peak
exercise strongly predicted their likelihood of dying in the following
few years.

"It's a dramatic finding which could have an impact on the way people
with serious coronary risk are screened or indeed whether you need to
go on to have fancier tests like nuclear heart scans of angiography
where your coronary blood vessels are catheterised and X-rayed.
...
"The person who led the research team was Dr Michael Lauer, a
cardiologist at the prestigious Cleveland Clinic in Cleveland, Ohio.

"Michael Lauer: We looked at something very simple; we looked at the
heart rate at the end of exercise, in people undergoing exercise
testing, and then we looked at their heart rate one minute after they
finished exercise. We took the difference between the heart rate at
peak exercise and the heart rate one minute later, and we measured the
heart rate recovery. We followed 2,400 patients for about six years,
during which time 213 of them died. And what we found was that this
change in heart rate during the first minute after exercise was an
extremely powerful predictor of mortality, in fact it was the most
powerful predictor of mortality that we've looked at; it was a more
powerful predictor of mortality than nuclear tests, which look at blood
flow abnormality to the heart, and it was a much more powerful
predictor of mortality than the electrocardiogram we physically looked
at during exercise."

I'm going to repeat that last part, adding emphasis:

 "...this change in heart rate during the first minute after exercise
was *an extremely powerful predictor of mortality",

  in fact *it was the *most* *powerful* predictor of mortality that
we've looked at*;

  it was a *more powerful predictor of mortality than nuclear tests*,
which look at blood flow abnormality to the heart,

and it was a *much* *more* *powerful* predictor of mortality than the
*electrocardiogram* we physically looked at during exercise."
Andrew B. Chung, MD/PhD - 20 Jan 2006 06:34 GMT
> > It seems to me I heard somewhere that Javier wrote in article
> > <1137698122.410675.37190@g14g2000cwa.googlegroups.com>:
[quoted text clipped - 71 lines]
> and it was a *much* *more* *powerful* predictor of mortality than the
> *electrocardiogram* we physically looked at during exercise."

Ime, this is because folks with metabolic syndrome (MetS) are the ones
who take the longest time for heart rate to recover (i.e. smaller
decrease in heart rate during the first minute after exercise) back to
baseline.

Would be more than happy to "glow" and chat about this and other things
like cardiology, diabetes, cooking and nutrition that interest those
following this thread here during the next on-line chat (01/26/06) from
6 to 7 pm EST:

http://tinyurl.com/cpayh

For those who are put off by the signature, my advance apologies for
how the LORD has reshaped me:

http://tinyurl.com/bgfqt

Prayerfully in Christ's love,

Andrew
http://tinyurl.com/b6xwk
Don Kirkman - 20 Jan 2006 08:41 GMT
It seems to me I heard somewhere that Andrew B. Chung, MD/PhD wrote in
article <1137738882.544505.297360@f14g2000cwb.googlegroups.com>:

>> > It seems to me I heard somewhere that Javier wrote in article
>> > <1137698122.410675.37190@g14g2000cwa.googlegroups.com>:

>> > >After a good one hour climbing interval session on my bike I took my
>> > >recovery heart rate via my HRM and I went from 126bpm to 81bpm in 2
>> > >minutes. Is this a good or bad recovery rate?

>> > ISTM a drop of 45 beats in two minutes is very good.  Runners tend to
>> > use a drop to a baseline rather than a numerical guideline, but
>> > typically might expect a drop from 140/150 to about 110 in two
>> > minutes--always subject to fitness level and the intensity and duration
>> > of the particular workout.

>> I few years ago, I remember reading an article that claimed the
>> recovery rate was one of the best predictors of mortality.

>> I just went and googled and found it, in the New England Journal of
>> Medicine.

>>   http://content.nejm.org/cgi/content/full/341/18/1351

>> Heart-Rate Recovery Immediately after Exercise as a Predictor of
>> Mortality
>> Christopher R. Cole, M.D., Eugene H. Blackstone, M.D., Fredric J.
>> Pashkow, M.D., Claire E. Snader, M.A., and Michael S. Lauer, M.D.

>> >From the results:
>>  "In univariate analyses, a low value for the recovery of heart rate
>> was strongly predictive of death (relative risk, 4.0; 95 percent
>> confidence interval, 3.0 to 5.2; P<0.001)."

>> There is an interview
>>   http://www.abc.net.au/rn/talks/8.30/helthrpt/stories/s63595.htm

>> In a six-year follow-up study, researchers showed that in a group of
>> men and women aged around 57, the heart rate one minute after peak
>> exercise strongly predicted their likelihood of dying in the following
>> few years.

>> "It's a dramatic finding which could have an impact on the way people
>> with serious coronary risk are screened or indeed whether you need to
>> go on to have fancier tests like nuclear heart scans of angiography
>> where your coronary blood vessels are catheterised and X-rayed.

>> "The person who led the research team was Dr Michael Lauer, a
>> cardiologist at the prestigious Cleveland Clinic in Cleveland, Ohio.

>> "Michael Lauer: We looked at something very simple; we looked at the
>> heart rate at the end of exercise, in people undergoing exercise
[quoted text clipped - 10 lines]
>> predictor of mortality than the electrocardiogram we physically looked
>> at during exercise."

>> I'm going to repeat that last part, adding emphasis:

>>   "...this change in heart rate during the first minute after exercise
>> was *an extremely powerful predictor of mortality",

>>    in fact *it was the *most* *powerful* predictor of mortality that
>> we've looked at*;

>>    it was a *more powerful predictor of mortality than nuclear tests*,
>> which look at blood flow abnormality to the heart,

>> and it was a *much* *more* *powerful* predictor of mortality than the
>> *electrocardiogram* we physically looked at during exercise."

>Ime, this is because folks with metabolic syndrome (MetS) are the ones
>who take the longest time for heart rate to recover (i.e. smaller
>decrease in heart rate during the first minute after exercise) back to
>baseline.

And what about the fifty, sixty, or so percent who do NOT have metabolic
syndrome?  Surely they don't all have fast recovery, since endurance
athletes seem to notice a correlation between fitness level and rapidity
of recovery.
Signature

Don Kirkman

Andrew B. Chung, MD/PhD - 20 Jan 2006 09:02 GMT
> It seems to me I heard somewhere that Andrew B. Chung, MD/PhD wrote in
> article <1137738882.544505.297360@f14g2000cwb.googlegroups.com>:
[quoted text clipped - 82 lines]
> And what about the fifty, sixty, or so percent who do NOT have metabolic
> syndrome?

Their recovery is faster.

> Surely they don't all have fast recovery, since endurance
> athletes seem to notice a correlation between fitness level and rapidity
> of recovery.

Those with a greater degree of correlation between fitness level and
rate of heart rate recovery also are the ones who tend to develop
metabolic syndrome with minimal weight gain during periods of
inactivity when they eat more.

Would be more than happy to "glow" and chat about this and other things
like cardiology, diabetes, cooking and nutrition that interest those
following this thread here during the next on-line chat (01/26/06) from
6 to 7 pm EST:

http://tinyurl.com/cpayh

For those who are put off by the signature, my advance apologies for
how the LORD has reshaped me:

http://tinyurl.com/bgfqt

Prayerfully in Christ's love,

Andrew
http://tinyurl.com/b6xwk
Chris Malcolm - 20 Jan 2006 13:13 GMT
>> It seems to me I heard somewhere that Andrew B. Chung, MD/PhD wrote in
>> article <1137738882.544505.297360@f14g2000cwb.googlegroups.com>:
>> >> > It seems to me I heard somewhere that Javier wrote in article
>> >> > <1137698122.410675.37190@g14g2000cwa.googlegroups.com>:

>> >> > >After a good one hour climbing interval session on my bike I took my
>> >> > >recovery heart rate via my HRM and I went from 126bpm to 81bpm in 2
>> >> > >minutes. Is this a good or bad recovery rate?

>> >> > ISTM a drop of 45 beats in two minutes is very good.  Runners tend to
>> >> > use a drop to a baseline rather than a numerical guideline, but
>> >> > typically might expect a drop from 140/150 to about 110 in two
>> >> > minutes--always subject to fitness level and the intensity and duration
>> >> > of the particular workout.

>> >> I few years ago, I remember reading an article that claimed the
>> >> recovery rate was one of the best predictors of mortality.

>> >> I just went and googled and found it, in the New England Journal of
>> >> Medicine.

>> >>   http://content.nejm.org/cgi/content/full/341/18/1351
>>
[quoted text clipped - 20 lines]
>> >> go on to have fancier tests like nuclear heart scans of angiography
>> >> where your coronary blood vessels are catheterised and X-rayed.

>> >> I'm going to repeat that last part, adding emphasis:
>>
[quoted text clipped - 6 lines]
>> >>    it was a *more powerful predictor of mortality than nuclear tests*,
>> >> which look at blood flow abnormality to the heart,

>> >> and it was a *much* *more* *powerful* predictor of mortality than the
>> >> *electrocardiogram* we physically looked at during exercise."

>> >Ime, this is because folks with metabolic syndrome (MetS) are the ones
>> >who take the longest time for heart rate to recover (i.e. smaller
>> >decrease in heart rate during the first minute after exercise) back to
>> >baseline.

Surely this is simply a statistical average rather than a general rule?

>> And what about the fifty, sixty, or so percent who do NOT have metabolic
>> syndrome?

> Their recovery is faster.

Ditto.

>> Surely they don't all have fast recovery, since endurance
>> athletes seem to notice a correlation between fitness level and rapidity
>> of recovery.

> Those with a greater degree of correlation between fitness level and
> rate of heart rate recovery also are the ones who tend to develop
> metabolic syndrome with minimal weight gain during periods of
> inactivity when they eat more.

Well, I'm a type 2 diabetic who's never gained much weight (except
once when taking prednisolone to control ulcerative colitis and my BMI
got up to as high as 24), and who displayed symptoms of metabolic
syndrome at least a decade before becoming diabetic. I've also had at
least one heart attack (my last two cardiologists disagree on whether
I've had one or two).  So I take careful note of the performance of my
heart, and avoid taking it over 140bpm. I'm 63, and ECG irregularities
which caused immediate cessation of a treadmill test and some anxious
hovering of the medical staff occurred somewhere over 150bpm. I felt
ok, but they gave me the impression I shouldn't go there :-)

So according to this discussion I'd expect to have a recovery rate on
the poorish side.

Yet consulting my records I see that over various different kinds of
sustained cardiovascular exertion in various states of fitness
(cycling up hills, walking up hills, doing high rep squats), my
recovery rate in the first minute after stopping varies between 20 and
30. When I'm unfit (as I am now) my resting pulse is in the low 50s,
and when I'm fit it's in the high 40s.

Which according to this discussion seems to be rather good.

Signature

Chris Malcolm cam@infirmatics.ed.ac.uk +44 (0)131 651 3445 DoD #205
IPAB,  Informatics,  JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]

Don Kirkman - 20 Jan 2006 22:08 GMT
It seems to me I heard somewhere that Andrew B. Chung, MD/PhD wrote in
article <1137747765.900064.171050@g43g2000cwa.googlegroups.com>:

[. . .]

>> >Ime, this is because folks with metabolic syndrome (MetS) are the ones
>> >who take the longest time for heart rate to recover (i.e. smaller
>> >decrease in heart rate during the first minute after exercise) back to
>> >baseline.

>> And what about the fifty, sixty, or so percent who do NOT have metabolic
>> syndrome?

>Their recovery is faster.

And your study supporting this opinion can be found where?

>> Surely they don't all have fast recovery, since endurance
>> athletes seem to notice a correlation between fitness level and rapidity
>> of recovery.

>Those with a greater degree of correlation between fitness level and
>rate of heart rate recovery also are the ones who tend to develop
>metabolic syndrome with minimal weight gain during periods of
>inactivity when they eat more.

What citations do you have for the opinions in that statement?  I.e.,
that they tend to develop ms, that they have minimal weight gain
(apparently in spite of) periods of inactivity, that they even have
meaningful periods of inactivity, or that they eat more during any such
periods that they have.
Signature

Don Kirkman

Andrew B. Chung, MD/PhD - 21 Jan 2006 04:08 GMT
> It seems to me I heard somewhere that Andrew B. Chung, MD/PhD wrote in
> article <1137747765.900064.171050@g43g2000cwa.googlegroups.com>:
[quoted text clipped - 12 lines]
>
> And your study supporting this opinion can be found where?

This is an observation and not an opinion.

> >> Surely they don't all have fast recovery, since endurance
> >> athletes seem to notice a correlation between fitness level and rapidity
[quoted text clipped - 10 lines]
> meaningful periods of inactivity, or that they eat more during any such
> periods that they have.

Again, these are observations rather than opinions.

Would be more than happy to "glow" and chat about this and other things
like cardiology, diabetes, cooking and nutrition that interest those
following this thread here during the next on-line chat (01/26/06) from
6 to 7 pm EST:

http://tinyurl.com/cpayh

For those who are put off by the signature, my advance apologies for
how the LORD has reshaped me:

http://tinyurl.com/bgfqt

Prayerfully in Christ's love,

Andrew
http://tinyurl.com/be9va
Don Kirkman - 20 Jan 2006 08:41 GMT
It seems to me I heard somewhere that Tony Wesley wrote in article
<1137730320.062765.113470@g49g2000cwa.googlegroups.com>:

>> It seems to me I heard somewhere that Javier wrote in article
>> <1137698122.410675.37190@g14g2000cwa.googlegroups.com>:

>> >After a good one hour climbing interval session on my bike I took my
>> >recovery heart rate via my HRM and I went from 126bpm to 81bpm in 2
>> >minutes. Is this a good or bad recovery rate?

>> ISTM a drop of 45 beats in two minutes is very good.  Runners tend to
>> use a drop to a baseline rather than a numerical guideline, but
>> typically might expect a drop from 140/150 to about 110 in two
>> minutes--always subject to fitness level and the intensity and duration
>> of the particular workout.

>I few years ago, I remember reading an article that claimed the
>recovery rate was one of the best predictors of mortality.

>I just went and googled and found it, in the New England Journal of
>Medicine.

>  http://content.nejm.org/cgi/content/full/341/18/1351

Thanks for this reference, Tony.  Javier and I are surely not the only
ones who should know this kind of study exists.

[balance snipped]
Signature

Don Kirkman

 
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