Disparity between estimates and measures of maximum heart rate in pilots with coronary artery disease
<p>Background : Several studies indicate that HRmax estimates using the traditional equation, HRmax = 220 - Age, may represent a regression slope and intercept that does reflect the true relationship between age and maximal cardiac frequency. Meta-analysis of several pertinent studies indicate...
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| Format: | Book |
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Journal of Cardiovascular Medicine and Cardiology - Peertechz Publications,
2018-10-18.
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| Online Access: | Connect to this object online. |
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| Summary: | <p>Background : Several studies indicate that HRmax estimates using the traditional equation, HRmax = 220 - Age, may represent a regression slope and intercept that does reflect the true relationship between age and maximal cardiac frequency. Meta-analysis of several pertinent studies indicates that 220-Age significantly under-estimates the true HRmax, particularly in older patients. This is a critical issue in the exercise evaluation of pilots with CAD who seek reinstatement of an aviation medical certificate after a cardiac illness because end-points in exercise testing and fitness assessment are based upon the 220--Age method of HRmax estimation. </p><p>Objective: This study was conducted to assess the accuracy of HRmax estimates made with the traditional method, 220-Age, in pilots with coronary artery disease </p><p>Methods: Nineteen male pilots, aged 46 to 82 years, with a history of CABG or multi-vessel PCI, exercised to exhaustion on a Bruce treadmill protocol. HRmax was measured from continuous 12-lead ECG and regressed on age by linear methods. The resulting regression equation was compared to other equations, including 220-Age. </p><p>Results: Measured HRmax was highly correlated with age (r = -0.95) and represented by the regression equation, HRmax = 226 - Age. HRmax estimates generated by the 220-Age method were significantly less (p<0.001) than measured HRmax. </p><p>Conclusions: The traditional method for predicting HRmax under-estimates the maximal cardiac frequency in male pilots with CAD. The accuracy of HRmax estimation for pilots with CAD was not improved by using regression equations derived by meta-analysis of several hundred studies.</p> |
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| DOI: | 10.17352/2455-2976.000069 |