Abstract

(1): Heart rate performance curve (HRPC) in incremental exercise was shown to be not uniform, causing false intensity estimation applying percentages of maximal heart rate (HRmax). HRPC variations are mediated by β-adrenergic receptor sensitivity. The aim was to study age and sex dependent differences in HRPC patterns in adults with β-blocker treatment (BB) and healthy controls (C). (2): A total of 535 (102 female) BB individuals were matched 1:1 for age and sex (male 59 ± 11 yrs, female 61 ± 11 yrs) in C. From the maximum incremental cycle ergometer exercise a first and second heart rate (HR) threshold (Th1 and Th2) was determined. Based on the degree of the deflection (kHR), HRPCs were categorized as regular (downward deflection (kHR > 0.1)) and non-regular (upward deflection (kHR < 0.1), linear time course). (3): Logistic regression analysis revealed a higher odds ratio to present a non-regular curve in BB compared to C (females showed three times higher odds). The odds for non-regular HRPC in BB versus C decreased with older age (OR interaction = 0.97, CI = 0.94–0.99). Maximal and submaximal performance and HR variables were significantly lower in BB (p < 0.05). %HRmax was significantly lower in BB versus C at Th2 (male: 77.2 ± 7.3% vs. 80.8 ± 5.0%; female: 79.2 ± 5.1% vs. 84.0 ± 4.3%). %Pmax at Th2 was similar in BB and C. (4): The HRPC pattern in incremental cycle ergometer exercise is different in individuals receiving β-blocker treatment compared to healthy individuals. The effects were also dependent on age and sex. Relative HR values at Th2 varied substantially depending on treatment. Thus, the percentage of Pmax seems to be a stable and independent indicator for exercise intensity prescription.

Highlights

  • To induce desired training effects and to apply safe exercise programs, exercise prescription is commonly based on fixed percentages of maximal heart rate (HRmax ) or maximal oxygen consumption (VO2max )

  • The groups were composed of 433 male (59 ± 11 yrs) and 102 female (61 ± 11 yrs) individuals treated with β-adrenoceptor antagonists (BB) who were exactly age- and sex-matched 1:1 with 433 male (59 ± 11 yrs) and 102 female (61 ± 11 yrs) healthy individuals in the control group (C)

  • Determination of Th1 and Th2 was successful in all cases except for two

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Summary

Introduction

To induce desired training effects and to apply safe exercise programs, exercise prescription is commonly based on fixed percentages of maximal heart rate (HRmax ) or maximal oxygen consumption (VO2max ). To 85% of HRmax or 50% to 75% of VO2max [1]. Fixed-percentage approaches were shown not to guarantee a uniform load amongst individuals [2,3]. Different metabolic responses, which may vary from over- to under-loading have been prescribed [4]. The inconsistency between intensity domains claims the need for adjustment and new indicators in intensity prescription, proposed by the 2020 position paper from the European. Individualized prescriptions based on cardiopulmonary exercise tests and individual thresholds such as the first and second ventilatory threshold are recommended [5,6,7]

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