Effects of β-blockers on maximal heart rate prediction equations in a cardiac population

Elizabeth Godlasky, Trisha Hoffman, Sonya Weber-Peters, Richard Bradford, Nathan Miller, Allen Kunselman, Mary E.J. Lott

Research output: Contribution to journalArticle

Abstract

Purpose: To derive specific maximal heart rate (HRmax) prediction equations for a coronary artery disease (CAD) population based upon status of β-blocker (BB) therapy and to compare these to prior HRmax equations (Fox and Brawner-specific for CAD). Methods: We retrospectively reviewed stress echocardiogram treadmill tests in patients with CAD, dividing subjects into 3 groups based upon BB use on test day: not prescribed BB therapy (no BB group; n = 110); held for 12 to 24 hr prior (held BB group; n = 155); and continued taking (took BB group; n = 72). Results: Derived HRmax equations for our CAD population were no BB = 200 − 0.79 × age; held BB = 193 – 0.71 × age; and took BB = 168 − 0.51 × age. Achieved HRmax mean was not significantly different between held BB and no BB groups; however, HRmax in the took BB group was significantly lower. Fox and Brawner (no BB)-HRmax equations significantly overestimated (+6 and +9 mean bias) and underestimated (−8 and −6 mean bias) achieved HRmax in no BB and held BB groups, respectively. The Brawner (no BB) equation intercept and slope were not significantly different from our CAD-held BB and no BB equations. The Brawner (on BB) equation intercept and slope were similar to our took BB equation, but greatly underestimated achieved HRmax (−17 mean bias). Conclusion: For patients holding BB therapy on test day, a similar CAD HRmax estimation equation to those patients never on BB can be used, comparable to the Brawner (no BB) equation. Further research is needed to determine when patients should take their BB therapy in conjunction with exercise testing.

Original languageEnglish (US)
Pages (from-to)111-117
Number of pages7
JournalJournal of Cardiopulmonary Rehabilitation and Prevention
Volume38
Issue number2
DOIs
StatePublished - Jan 1 2018

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Coronary Artery Disease
Heart Rate
Population
Therapeutics
Exercise Test
Exercise
Research

All Science Journal Classification (ASJC) codes

  • Rehabilitation
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Godlasky, Elizabeth ; Hoffman, Trisha ; Weber-Peters, Sonya ; Bradford, Richard ; Miller, Nathan ; Kunselman, Allen ; Lott, Mary E.J. / Effects of β-blockers on maximal heart rate prediction equations in a cardiac population. In: Journal of Cardiopulmonary Rehabilitation and Prevention. 2018 ; Vol. 38, No. 2. pp. 111-117.
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abstract = "Purpose: To derive specific maximal heart rate (HRmax) prediction equations for a coronary artery disease (CAD) population based upon status of β-blocker (BB) therapy and to compare these to prior HRmax equations (Fox and Brawner-specific for CAD). Methods: We retrospectively reviewed stress echocardiogram treadmill tests in patients with CAD, dividing subjects into 3 groups based upon BB use on test day: not prescribed BB therapy (no BB group; n = 110); held for 12 to 24 hr prior (held BB group; n = 155); and continued taking (took BB group; n = 72). Results: Derived HRmax equations for our CAD population were no BB = 200 − 0.79 × age; held BB = 193 – 0.71 × age; and took BB = 168 − 0.51 × age. Achieved HRmax mean was not significantly different between held BB and no BB groups; however, HRmax in the took BB group was significantly lower. Fox and Brawner (no BB)-HRmax equations significantly overestimated (+6 and +9 mean bias) and underestimated (−8 and −6 mean bias) achieved HRmax in no BB and held BB groups, respectively. The Brawner (no BB) equation intercept and slope were not significantly different from our CAD-held BB and no BB equations. The Brawner (on BB) equation intercept and slope were similar to our took BB equation, but greatly underestimated achieved HRmax (−17 mean bias). Conclusion: For patients holding BB therapy on test day, a similar CAD HRmax estimation equation to those patients never on BB can be used, comparable to the Brawner (no BB) equation. Further research is needed to determine when patients should take their BB therapy in conjunction with exercise testing.",
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Effects of β-blockers on maximal heart rate prediction equations in a cardiac population. / Godlasky, Elizabeth; Hoffman, Trisha; Weber-Peters, Sonya; Bradford, Richard; Miller, Nathan; Kunselman, Allen; Lott, Mary E.J.

In: Journal of Cardiopulmonary Rehabilitation and Prevention, Vol. 38, No. 2, 01.01.2018, p. 111-117.

Research output: Contribution to journalArticle

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