BehindTheMedspeak: If just thinking about exercising makes your heart beat faster, you've got a problem

Long story short: Men whose heart rate increased by more than 12 beats per minute while sitting on an exercise bike before exercising were twice as likely to die of a sudden heart attack later in life than men whose heart rate increased by less than 4 beats a minute just sitting on the bike.

Here's the abstract of the study, published online April 28, 2009 in the European Heart Journal.

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Excessive heart rate increase during mild mental stress in preparation for exercise predicts sudden death in the general population

Aims: The aim of this study involves the early identification, among apparently healthy individuals, of those at high risk for sudden cardiac death. We tested the hypothesis that individuals who respond to mild mental stress in preparation for exercise test with the largest heart rate increases might be at highest risk.

Methods and results: Data from 7746 civil servants participating in the Paris Prospective Study I, followed-up for 23 years, allowed to compare heart rate changes between rest and mild mental stress (preparation prior to an exercise test) between subjects who suffered sudden cardiac death (n = 81), non-sudden (n = 129) coronary death, or death from any cause (n = 1306). The mean heart rate increase during mild mental stress was 8.9 ± 10.8 b.p.m. Risk of sudden cardiac death increased progressively with heart rate increase during mental stress and the relative risk of the third vs. the first tertile was 2.09 (95% confidence interval, 1.13–3.86) after adjustment for confounders. This relationship was not observed for non-sudden coronary death.

Conclusion: An important heart rate increase produced by a mild mental stress predicts long-term risk for sudden cardiac death. Heart rate changes before an exercise test may provide a simple tool for risk stratification.

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Nice overview of the study here.

Download the paper (free) as a PDF file here.