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J Am Coll Cardiol, 2001; 37:153-156
© 2001 by the American College of Cardiology Foundation
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CLINICAL STUDY: EXERCISE TESTING

Age-predicted maximal heart rate revisited

Hirofumi Tanaka, PhDa, Kevin D. Monahan, MSa and Douglas R. Seals, PhDa,b

a Human Cardiovascular Research Laboratory, Department of Kinesiology and Applied Physiology, University of Colorado at Boulder, Boulder, Colorado, USA
b Divisions of Cardiology and Geriatric Medicine, Department of Medicine, University of Colorado Health Sciences Center, Denver, Colorado, USA

Manuscript received April 18, 2000; revised manuscript received July 24, 2000, accepted September 13, 2000.

Reprint requests and correspondence: Dr. Hirofumi Tanaka, Department of Kinesiology and Applied Physiology, Campus Box 354, University of Colorado at Boulder, Boulder, Colorado 80309-0354
tanakah{at}colorado.edu

OBJECTIVES

We sought to determine a generalized equation for predicting maximal heart rate (HRmax) in healthy adults.

BACKGROUND

The age-predicted HRmax equation (i.e., 220 – age) is commonly used as a basis for prescribing exercise programs, as a criterion for achieving maximal exertion and as a clinical guide during diagnostic exercise testing. Despite its importance and widespread use, the validity of the HRmax equation has never been established in a sample that included a sufficient number of older adults.

METHODS

First, a meta-analytic approach was used to collect group mean HRmax values from 351 studies involving 492 groups and 18,712 subjects. Subsequently, the new equation was cross-validated in a well-controlled, laboratory-based study in which HRmax was measured in 514 healthy subjects.

RESULTS

In the meta-analysis, HRmax was strongly related to age (r = –0.90), using the equation of 208 – 0.7 x age. The regression equation obtained in the laboratory-based study (209 – 0.7 x age) was virtually identical to that obtained from the meta-analysis. The regression line was not different between men and women, nor was it influenced by wide variations in habitual physical activity levels.

CONCLUSIONS

1) A regression equation to predict HRmax is 208 – 0.7 x age in healthy adults. 2) HRmax is predicted, to a large extent, by age alone and is independent of gender and habitual physical activity status. Our findings suggest that the currently used equation underestimates HRmax in older adults. This would have the effect of underestimating the true level of physical stress imposed during exercise testing and the appropriate intensity of prescribed exercise programs.

Abbreviations and Acronyms
  HRmax = maximal heart rate
  ;-1qO2 = minute oxygen consumption




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