Heart Rate Recovery – Give me the beat

In our first few episodes, we have covered quite a bit about common metrics and indicators of cardiovascular health and fitness, particularly discussing VO2 Max and heart rate variability. In our fourth episode, we are going to take a look at another tool in our physical fitness toolkit: heart rate recovery.

What is Heart Rate Recovery?

Heart rate recovery is simply the change in your heart rate after exercise, back towards resting levels. The rate at which your heart rate drops (typically evaluated at 1, 2, or 3 minute marks) can be an indicator of a person’s overall physical fitness and health. For example, if your heart rate at the end of exercise is 175 beats per minute (bpm), and two minutes after resting, your heart rate comes down to 130 bpm, then your heart rate recovery (HRR) is 45 bpm (175 – 130 = 45).

How does that work, physiologically?

If you recall back to episode one, our bodies are regulated by the autonomic nervous system (the driver behind our heart rate variability). In this system, we have a parasympathetic response (rest and relaxation) and a sympathetic nervous system (fight or flight).

As we start to exercise, our fight or flight response kicks in and our body readies itself for activity, allowing us to become more efficient in our ability to perform, utilize energy, etc. (Side note: this is why warm-ups are thought to be helpful [1]).

Once we stop exercising, we experience a withdrawal of the sympathetic system, and a reactivation of the parasympathetic nervous system. Our bodies recognize that the work is complete and make the appropriate modifications.

Now, this process takes more than just a few minutes. In fact, the activation of the sympathetic system and reactivation of the parasympathetic system (sometimes referred to as ‘vagal tone’) can take hours and even up to a day according to some studies [2–4].

Seems simple enough, but why do I care?

While there are multiple factors that play a role on our autonomic nervous system, there are two main reasons we should care about heart rate recover:

1. It has been shown to be linked to increased mortality and cardiometabolic diseases (i.e. heart disease, diabetes, etc).

2. We can use it as a monitor for our own improvements in physical health (ideally decreasing our risks of #1).

Heart rate recovery has been extensively studied in the past, particularly as it relates to cardiovascular disease and mortality.

In a systematic review in 2017, researchers compared different groups categorized by their heart rate recoveries. They found that groups with lower heart rate recovery had an increased rate of adverse events. In fact, they estimated that for every decrease in HRR of about 10 bpm, there was a 13% increase in cardiovascular events, such as heart attack or stroke, and a 9% increase in death from any cause!

As we train, we can improve our HRR numbers as well as our other metrics. Interestingly, (at least from a clinical medicine perspective) heart rate recovery scores have been tracked and improved in patients undergoing cardiac rehabilitation following heart attacks and cardiac disease [6,7].  

In any case, we know that well-trained athletes have better (higher) heart rate recoveries, compared to untrained individuals [8]. Indeed, well-trained (elite) athletes can have one-minute heart rate drops of up to 30 beats per minute!

So what do my numbers mean?

Athlytic uses a 2-minute heart rate recovery score. While there have been many studies that have looked at heart rate recoveries at various time-points (ten seconds, one minute, two minutes, five minutes, etc), each offers a slightly different perspective on the individual, likely incorporating slightly different parasympathetic and sympathetic variables.

The two-minute recovery has been shown to be a reliable metric to monitor after exercise [9]. Some studies note that it is the best measure to predict clinical outcomes (like mortality and heart disease [10]) and outperforms heart rate recovery at other intervals [11]. It is likely that shorter durations (30 seconds, 1 minute) may be more susceptible to day-to-day variability or even mode of exercise [12].

Final thoughts

Heart rate recovery is another tool in the Athlytic toolshed to monitor your fitness and performance. While various factors will play a role in your day-to-day variability, such as workout intensity, hydration status, sleep, caffeine intake, etc., watching your trends over time offers valuable insight into your growth—in  both fitness and health!

We all know recovery is key – unlock the insights behind your heart rate recovery.

Sources and further readings

1. Warm-Up Intensity and Time Course Effects on Jump Performance - PMC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7675624/

2. Terziotti P, Schena F, Gulli G, Cevese A. Post-exercise recovery of autonomic cardiovascular control: a study by spectrum and cross-spectrum analysis in humans. Eur J Appl Physiol. 2001;84(3):187-194. doi:10.1007/s004210170003

3. Hautala A, Tulppo MP, Mäkikallio TH, Laukkanen R, Nissilä S, Huikuri HV. Changes in cardiac autonomic regulation after prolonged maximal exercise. Clin Physiol Oxf Engl. 2001;21(2):238-245. doi:10.1046/j.1365-2281.2001.00309.x

4. Furlan R, Piazza S, Dell’Orto S, et al. Early and late effects of exercise and athletic training on neural mechanisms controlling heart rate. Cardiovasc Res. 1993;27(3):482-488. doi:10.1093/cvr/27.3.482

5. Qiu S, Cai X, Sun Z, et al. Heart Rate Recovery and Risk of Cardiovascular Events and All-Cause Mortality: A Meta-Analysis of Prospective Cohort Studies. J Am Heart Assoc. 2017;6(5):e005505. doi:10.1161/JAHA.117.005505

6. El Missiri A, Amin SA, Tawfik IR, Shabana AM. Effect of a 6-week and 12-week cardiac rehabilitation program on heart rate recovery. Egypt Heart J. 2020;72:69. doi:10.1186/s43044-020-00107-8

7. Manresa-Rocamora A, Sarabia JM, Guillen-Garcia S, et al. Heart Rate Variability-Guided Training for Improving Mortality Predictors in Patients with Coronary Artery Disease. Int J Environ Res Public Health. 2022;19(17):10463. doi:10.3390/ijerph191710463

8. Du N, Bai S, Oguri K, et al. Heart rate recovery after exercise and neural regulation of heart rate variability in 30-40 year old female marathon runners. J Sports Sci Med. 2005;4(1):9-17.

9. Tulumen E, Khalilayeva I, Aytemir K, et al. The Reproducibility of Heart Rate Recovery after Treadmill Exercise Test. Ann Noninvasive Electrocardiol. 2011;16(4):365-372. doi:10.1111/j.1542-474X.2011.00464.x

10. Lipinski MJ, Vetrovec GW, Froelicher VF. Importance of the first two minutes of heart rate recovery after exercise treadmill testing in predicting mortality and the presence of coronary artery disease in men. Am J Cardiol. 2004;93(4):445-449. doi:10.1016/j.amjcard.2003.10.039

11. Shetler K, Marcus R, Froelicher VF, et al. Heart rate recovery: validation and methodologic issues. J Am Coll Cardiol. 2001;38(7):1980-1987. doi:10.1016/S0735-1097(01)01652-7

12. Maeder MT, Ammann P, Rickli H, Brunner-La Rocca HP. Impact of the exercise mode on heart rate recovery after maximal exercise. Eur J Appl Physiol. 2009;105(2):247-255. doi:10.1007/s00421-008-0896-2