 should be reassured that they are at little risk.
"If a patient has a normal heart rate recovery and normal exercise stress test, I tell them that everything looks great for them, that they have a risk for having a major life-threatening problem of less than one half of 1% per year," he says. "If the test is abnormal, the risk moves up to 3% or 5% per year. That means we really have to get to work."
So what are those who have abnormal heart rate recovery times to do? According to Lauer, they should be even more motivated to become healthier and reduce their risk for heart disease.
"People who had abnormal heart rate recovery times are at increased risk for [heart disease] so that everything that can be fixed, should be," Lauer says. He suggests:
- Smokers should break the habit.
- High cholesterol levels should be brought down.
- Diabetes should be kept under control.
- Overweight should people lose weight.
- Those with blockages in the blood vessels should seek aggressive treatment.
Lauer has done several studies of heart rate recovery, but he tells WebMD that this one is different because it was done in such a large number of patients who had no symptoms of heart disease.
"Most of them were referred for testing as part of screening, meaning that they didn't have any symptoms of heart disease, but for whatever reason, their doctors thought they may be at risk for heart disease," he explains.
He adds that as a result, he now orders stress tests more readily in his own patients. "Since our original paper came out over a year ago, we now routinely incorporate heart rate recovery into virtually every stress test that we do," Lauer says. "In my own practice, I send patients for exercise stress tests with a lot more enthusiasm than I used to because I know that the test has a lot more information than I used to think that it did," he concludes.
Also convinced is Gerald F. Fletcher, MD, professor at the Mayo Clinic in Jacksonville, Fla., who says that these results and those previously seen from these same researchers have convinced him that heart rate recovery should be added to all stress testing.
"If the heart rate recovery is not rapid enough, it's a marker of not-so-good things to come," he tells WebMD, but adds that this information needs to be seen in the bigger picture created by the other factors in testing. "If heart rate recovery is not so good, but everything else is [good], you can't put too much into it."
Fletcher adds, "Heart rate response, heart rate recovery, [blood pressure] response, [blood pressure] recovery, time on the treadmill -- all these things are very important. We can get a lot of information out of a relatively inexpensive test," he concludes.