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      HR Max Prediction Based on Age, Body Composition, Fitness Level, Testing Modality and Sex in Physically Active Population

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          Abstract

          Maximal heart rate (HRmax) is associated mostly with age, but age alone explains the variance in HRmax to a limited degree and may not be adequate to predict HRmax in certain groups. The present study was carried out on 3374 healthy Caucasian, Polish men and women, clients of a sports clinic, mostly sportspeople, with a mean age of 36.57 years, body mass 74.54 kg, maximum oxygen uptake (VO 2max, ml kg –1 min –1) 50.07. Cardiopulmonary exercise tests (CPET) were carried out on treadmills or cycle ergometers to evaluate HRmax and VO 2max. Linear, multiple linear, stepwise, Ridge and LASSO regression modeling were applied to establish the relationship between HRmax, age, fitness level, VO 2max, body mass, age, testing modality and body mass index (BMI). Mean HRmax predictions calculated with 5 previously published formulae were evaluated in subgroups created according to all variables. HRmax was univariately explained by a 202.5–0.53 age formula ( R 2 = 19.18). The weak relationship may be explained by the similar age with small standard deviation (SD). Multiple linear regression, stepwise and LASSO yielded an R 2 of 0.224, while Ridge yielded R 2 0.20. Previously published formulae were less precise in the more outlying groups of the studied population, overestimating HRmax in older age groups and underestimating in younger. The 202.5–0.53 age formula developed in the present study was the best in the studied population, yielding lowest mean errors in most groups, suggesting it could be used in more active individuals. Tanaka’s formula offers the second best overall prediction, while the 220-age formula yields remarkably high mean errors of up to 9 bpm. In conclusion, adding the studied variables in multiple regression models improves the accuracy of prediction only slightly over age alone and is unlikely to be useful in clinical practice.

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          Age-predicted maximal heart rate revisited.

          We sought to determine a generalized equation for predicting maximal heart rate (HRmax) in healthy adults. 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. 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. 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. 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.
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            Age-predicted maximal heart rate in healthy subjects: The HUNT fitness study.

            Maximal heart rate (HRmax ) declines substantially with age, but the magnitude and possible modifying effect of gender, body composition, and physical activity are not fully established. The present study examined the relationship between HRmax and age in 3320 healthy men and women within a wide age range using data from the HUNT Fitness Study (2007-2008). Subjects were included if a maximal effort could be verified during a maximal exercise test. General linear modeling was used to determine the effect of age on HRmax . Subsequently, the effects of gender, body mass index (BMI), physical activity status, and maximal oxygen uptake were examined. Mean predicted HRmax by three former prediction formulas were compared with measured HRmax within 10-year age groups. HRmax was univariately explained by the formula 211 - 0.64·age (SEE, 10.8), and we found no evidence of interaction with gender, physical activity, VO2max level, or BMI groups. There were only minor age-adjusted differences in HRmax between these groups. Previously suggested prediction equations underestimated measured HRmax in subjects older than 30 years. HRmax predicted by age alone may be practically convenient for various groups, although a standard error of 10.8 beats/min must be taken into account. HRmax in healthy, older subjects and women were higher than previously reported. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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              Graded Exercise Testing Protocols for the Determination of VO2max: Historical Perspectives, Progress, and Future Considerations

              Graded exercise testing (GXT) is the most widely used assessment to examine the dynamic relationship between exercise and integrated physiological systems. The information from GXT can be applied across the spectrum of sport performance, occupational safety screening, research, and clinical diagnostics. The suitability of GXT to determine a valid maximal oxygen consumption (VO2max) has been under investigation for decades. Although a set of recommended criteria exists to verify attainment of VO2max, the methods that originally established these criteria have been scrutinized. Many studies do not apply identical criteria or fail to consider individual variability in physiological responses. As an alternative to using traditional criteria, recent research efforts have been directed toward using a supramaximal verification protocol performed after a GXT to confirm attainment of VO2max. Furthermore, the emergence of self-paced protocols has provided a simple, yet reliable approach to designing and administering GXT. In order to develop a standardized GXT protocol, additional research should further examine the utility of self-paced protocols used in conjunction with verification protocols to elicit and confirm attainment of VO2max.
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                Author and article information

                Contributors
                Journal
                Front Physiol
                Front Physiol
                Front. Physiol.
                Frontiers in Physiology
                Frontiers Media S.A.
                1664-042X
                30 July 2021
                2021
                : 12
                : 695950
                Affiliations
                [1] 1III Klinika Chorób Wewnętrznych i Kardiologii, Warszawski Uniwersytet Medyczny (WUM) , Warsaw, Poland
                [2] 2Department of Physical Education and Health in Biala Podlaska, Jozef Pilsudski University of Physical Education in Warsaw Faculty in Biala Podlaska , Biala Podlaska, Poland
                [3] 3Public Health School Centrum Medyczne Kształcenia Podyplomowego (CMKP) , Warsaw, Poland
                [4] 4Wydział Matematyki i Nauk Informacyjnych, Politechnika Warszawska , Warsaw, Poland
                [5] 5Department of Experimental and Clinical Pharmacology, Center for Preclinical Research and Technology (CEPT), Medical University of Warsaw , Warsaw, Poland
                [6] 6Institute of Primary Care, University of Zurich , Zurich, Switzerland
                [7] 7Medbase St. Gallen Am Vadianplatz , St. Gallen, Switzerland
                Author notes

                Edited by: Anthony S. Leicht, James Cook University, Australia

                Reviewed by: Daniel Boullosa, Federal University of Mato Grosso do Sul, Brazil; Trine Karlsen, Nord University, Norway

                This article was submitted to Exercise Physiology, a section of the journal Frontiers in Physiology

                Article
                10.3389/fphys.2021.695950
                8362801
                34393819
                2ae0bc48-8152-490d-bd91-c98c8b1c2b8f
                Copyright © 2021 Lach, Wiecha, Śliż, Price, Zaborski, Cieśliński, Postuła, Knechtle and Mamcarz.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 15 April 2021
                : 14 June 2021
                Page count
                Figures: 3, Tables: 3, Equations: 0, References: 27, Pages: 9, Words: 0
                Categories
                Physiology
                Original Research

                Anatomy & Physiology
                hrmax,220-age,cardiopulmonary testing,formulae,body composition,aerobic performance,treadmill ambulation,cycle ergometer

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