A longitudinal study of physical activity and heart rate recovery: CARDIA, 1987-1993

Purpose: Autonomic nervous system function may be a mechanism by which frequent physical activity is associated with better coronary heart disease outcomes. In a diverse, population-based sample, we tested whether physical activity participation was associated with higher parasympathetic function. Methods: Participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study underwent symptom-limited graded exercise testing at baseline (1985-1986; N = 3446) and at 7 yr follow-up (N = 1627). Heart rate recovery (HRR), the difference between maximum heart rate (HR) and HR 2 min after test cessation, was used to estimate parasympathetic activity. Results: Participants who self-reported in the highest fertile of total physical activity (the sum of moderate- and heavy-intensity activities) had significantly faster HRR than participants in the lowest fertile (45.1 vs 41.8 beats·min^-1, P < 0.01), and the odds of having abnormal HRR (≤22 beats·min ^-1) were 1.9 (95% confidence interval: 1.1, 3.4) times greater in the lowest versus the highest tertile after adjustment for age, race, gender, body mass index, smoking status, and diastolic blood pressure. Findings were consistent across strata of covariates. On average, HRR declined 2.5 beats·min^-1 over 7 yr. HRR declined the least among participants whose physical activity increased (-1.3 beats·min ^-1) or remained stable (-1.8 beats·min^-1), compared with participants whose physical activity decreased (-3.6 beats·min ^-1; P < 0.01 vs increase or stable). Conclusions: In this diverse, population-based sample, physical activity was associated with faster HRR from an exercise treadmill test. Regular physical activity may blunt age-related declines in autonomic nervous system function.