Expert: Todd Bublitz, RCEP - 10/7/2004

Question
Hi Todd

I just did an exercise stress test and I did hit the max heart rate of 190 but it took my about 5 minutes to return to below 100.   The assistant said that it should take 2 minutes for an average person to drop back to normal.  So I want to start training my heart by doing some cardio.   I am 35.  What cardio exercise do you recommend?   What heart rate should I hit and for how long?

Thanks

HT  

Answer
HT,

With all due respect, that "assistant" is a moron and is wrong (in my opinion).

I think this is a case of "a little knowledge is dangerous thing".

Nowhere in the literature could I find any reference to "it should take 2 minutes for an average person to drop back to normal."

However, here are some studies of heart rate recovery and their definition(s):

Heart-Rate Recovery Immediately after Exercise as a Predictor of Mortality (NEJM Vol 341:1351-1357  October 28, 1999  Number 18)
"The value for the recovery of heart rate was defined as the decrease in the heart rate from peak exercise to one minute after the cessation of exercise. An abnormal value for the recovery of heart rate was defined as a reduction of 12 beats per minute or less from the heart rate at peak exercise."
http://content.nejm.org/cgi/content/abstract/341/18/1351

Heart rate recovery after submaximal exercise testing as a predictor of mortality in a cardiovascularly healthy cohort (Ann Intern Med. 2000 Apr 4;132(7):552-5.)
"Heart rate recovery was defined as the change from peak heart rate to that measured 2 minutes later (abnormal heart rate recovery was defined as < or =42 beats/min)."
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstra...
(HT, according to this your heart rate should be at 147 bpm or less 2 min after your test to be "normal".)

Association of educational status with heart rate recovery: a population-based propensity analysis.  (Am J Med. 2002 Dec 1;113(8):643-9.)
"An abnormal heart rate recovery was defined as a difference of </=42 beats per minute between the peak heart rate and that after 2 minutes of recovery."
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstra...

Heart rate recovery: validation and methodologic issues.
(J Am Coll Cardiol. 2001 Dec;38(7):1980-7.)
"Heart rate recovery at 2 min after exercise outperformed other time points in prediction of death; a decrease of <22 beats/min had a hazard ratio of 2.6 (increased risk)."
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstra...

The best cardiopulmonary exercises are walking/jogging, bicycling, cross-country skiing, swimming, stair climbing, aerobic dancing, getting the picture.  Any exercise that is continuous, and performed at a moderate pace so you can continue the exercise for at least 20 minutes - but up to 40-60 minutes is ideal.

HT, your heart rate should be about 60-80% of your maximum.  Since you know your maximum heart rate is 190, 60-80% would be 114-152 beats per minute.  If you d not know your maximum heart rate, the old stand-by is to take 220 minus your age (220-35=185 maximum).  Then take 60% & 80% of 185 (111-148 bpm).

Lastly, do me a favor and ask that "assistant" to give you the reference for their "it should take 2 minutes for an average person to drop back to normal."  I'll bet they say, "I heard it once from somebody."

Best wishes.

Todd
ACSM Registered Clinical Exercise Physiologist
ACSM Certified Exercise Specialist
ACSM Certified Exercise Test Technologist
Knows how to perform a medical literature search