New Formula for Peak Heart Rate During Exercise
Developed for Older Men, Women
Everybody's peak heart rate declines with age, but
decline is more gradual in women
March 27, 2014 A study of more than 25,000 stress
tests by older people convinced researchers that the current formula for
determining a persons peak exercise heart rate had to be changed. It
was used by doctors for decades to diagnose heart conditions but the
study says it was flawed because it failed to recognize differences
between men and women, particularly as they age.
The researchers found significant differences
between men and women and developed an updated formula to reflect those
nuances, which is being presented at the American College of
Cardiology's 63rd Annual Scientific Session.
The old and simple formula of "220 minus age" has
been widely used to calculate the maximum number of heart beats per
minute a person can achieve. Many people use it to derive their target
heart rate during a workout. Doctors use it to determine how hard a
patient should exercise during a common diagnostic test known as the
exercise stress test.
"The standard that's currently in use is somewhat
outdated," said Thomas Allison, M.D., cardiologist and director of
stress testing at Mayo Clinic, and senior author of the study.
"We want to make sure that when people do the
stress test, they have an accurate expectation of what a normal peak
heart rate is. Every so often, you need to recalibrate what's considered
The new formula can help people better optimize
their workouts and also improve the accuracy of test results. Stress
tests, which are commonly used to help diagnose conditions such as
coronary heart disease, heart valve disease and heart failure, require
patients to exercise near their top capacity while technicians monitor
the patient's cardiac performance.
The researchers drew data from 25,000 patients who
took stress tests at Mayo Clinic between 1993 and 2006. The sample
included men and women 40 to 89 years of age who had no history of
The study reveals that although everybody's peak
heart rate declines with age, the decline is more gradual in women. As a
result, the previous formula overestimates the peak heart rate younger
women can achieve and underestimates the peak heart rate of older women.
The new recommendations are:
>> Women in the
age range of 40 to 89 years should expect their maximum heart rate to be
200 minus 67 percent of their age.
>> Men in the age
range of 40 to 89 years should use 216 minus 93 percent of their age.
For women younger than 40, the relationship of
heart rate to age may be different, as an insufficient number of tests
on women younger than 40 were available to provide reliable results.
The study also showed that younger men have a lower
resting heart rate and higher peak heart rate than women and that men's
heart rates rise more dramatically during exercise and return to normal
more quickly after stopping. The study did not investigate the
physiological reasons behind the differences, although the researchers
suggest hormones, especially testosterone, may play a role.
The previous formula was based on a study
researchers now recognize as having serious limitations. For example, it
included few women, a weakness common among older studies.
"It's logical that an equation developed 40 years
ago based on a group that was predominantly men might not be accurate
when applied to women today," Allison said. "But sometimes things just
Changes since the 1970s in terms of average body
weight, fitness levels and attitudes toward exercise particularly
among women justify a re-evaluation of peak heart rate norms, Allison
said. Other recent studies have offered updates to the formula, but this
study uses a larger sample size and is the first to include data from
both men and women.
The ACC's Annual Scientific Session brings together
cardiologists and cardiovascular specialists from around the world each
year to share the newest discoveries in treatment and prevention. Follow
@ACCMediaCenter and #ACC14 for the latest news from the meeting.
The American College of Cardiology is a nonprofit
medical society comprised of 47,000 physicians, surgeons, nurses,
physician assistants, pharmacists and practice managers. The College is
dedicated to transforming cardiovascular care, improving heart health
and advancing quality improvement, patient-centered care, payment
innovation and professionalism.
The ACC also leads the formulation of
important cardiovascular health policy, standards and guidelines. It
bestows credentials upon cardiovascular specialists, provides
professional education, supports and disseminates cardiovascular
research, and operates national registries to measure and promote
quality care. For more information, visit
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