Heart Rate Recovery (HRR) is a simple but powerful indicator of cardiovascular fitness, overall heart health. It measures how quickly your heart rate drops after exercise, reflecting autonomic nervous system function.
Recent research suggests that HRR at 10 seconds post-exercise (HRR10) is the strongest predictor of heart health and longevity, even more so than the traditional 1-minute measure (HRR60).
As ever, please talk to your doctor or medical practitioner most familiar with your medical history before implementing any changes in diet, exercise or lifestyle, especially if you are under treatment. Links to all studies at bottom of page.
Why Heart Rate Recovery Matters
A meta-analysis of prospective cohort studies (Qiu et al, 2017) found that for every 10 bpm decrease in HRR, the risk of cardiovascular events rises by 13%, while the risk of all-cause mortality increases by 9%. Importantly, this association remains independent of traditional metabolic risk factors such as obesity, diabetes and dyslipidaemia.
HRR reflects autonomic nervous system function, with a slower recovery indicating reduced parasympathetic activity and heightened sympathetic dominance. This imbalance contributes to increased cardiovascular strain, insulin resistance, chronic inflammation, and a higher likelihood of fatal arrhythmias. While HRR measured at both 10 seconds, 1 and 2 minutes post-exercise is predictive of mortality, HRR at 2 minutes may be more sensitive for identifying cardiovascular risk.
Encouragingly, studies suggest that individuals with initially poor HRR who improve it through exercise and rehabilitation achieve survival rates comparable to those with consistently healthy HRR.
What You Need
Ideally, a heart rate monitor (chest strap, smartwatch).
A treadmill, stationary bike or a flat running area.
A timer or stopwatch.
A way to record results (app, spreadsheet, notebook).
Test Protocol
Preparation
Avoid caffeine, alcohol, and large meals 2 hours before.
Warm up for 5 to 10 minutes with light activity.
Exercise Phase
Engage in moderate to intense exercise (running, cycling, brisk walking) for 5 to 6 minutes.
Reach 70 to 85% of your maximum heart rate; the upper end of Zone 3, low Zone 4. (about a 7, maybe 8, out of 10 effort)
Many people, and default settings on sports watches, use the max heart rate calculation 220 minus age to calculate heart rate zones. It is worthwhile to know, to test, your actual maximum heart rate for a more accurate result. My max heart rate is within a couple of beats of the predicted number, for others it can diverge significantly.
Cessation & HRR Measurement
Stop immediately and stand or sit still.
Measure your heart rate at:
Peak exercise (HRmax)
10 seconds post-exercise (HRR10)
1 minute post-exercise (HRR60)
If using a sports watch, the lap button should capture the data at the appropriate times.
Calculating HRR
HRR10 = Peak HR minus HR at 10 seconds
HRR60 = Peak HR minus HR at 1 minute
Example:
Peak HR: 170 BPM
HR at 10 sec: 152 BPM → HRR10 = 18 BPM
HR at 1 min: 140 BPM → HRR60 = 30 BPM
Interpreting Your Results
HRR10 (Best Predictor of Heart Health)
≥ 18 BPM drop → Excellent
12–17 BPM drop → Moderate fitness
≤ 11 BPM drop → Poor heart health, potential risks
HRR60 (Traditional Measure)
≥ 20 BPM drop → Healthy
15–19 BPM drop → Average fitness
≤ 12 BPM drop → Higher risk of cardiovascular disease
Final Thoughts
Heart rate recovery is a valuable, easy-to-measure marker of cardiovascular health. The 10second drop is the best predictor of heart health and longevity, with a slower decline linked to higher cardiovascular risk and mortality. By tracking and improving your HRR, you can gain insights into your fitness levels and take proactive steps towards a stronger, healthier heart. Be consistent with your exercise and retest after a few months. Surprisingly, this is not a measurement that I have seen as a feature on smart / sports watches.
Another 'at home' test - to assess functional health and mortality risk - is the sitting rising test; learn more here.
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Alastair
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Related Studies
van de Vegte YJ, van der Harst P, Verweij N. Heart Rate Recovery 10 Seconds After Cessation of Exercise Predicts Death. J Am Heart Assoc. 2018 Apr 5;7(8):e008341. doi: 10.1161/JAHA.117.008341. PMID: 29622586; PMCID: PMC6015434.
Qiu S, Cai X, Sun Z, Li L, Zuegel M, Steinacker JM, Schumann U. Heart Rate Recovery and Risk of Cardiovascular Events and All-Cause Mortality: A Meta-Analysis of Prospective Cohort Studies. J Am Heart Assoc. 2017 May 9;6(5):e005505. doi: 10.1161/JAHA.117.005505. PMID: 28487388; PMCID: PMC5524096.
Huang PH, Leu HB, Chen JW, Lin SJ. Heart rate recovery after exercise and endothelial function--two important factors to predict cardiovascular events. Prev Cardiol. 2005 Summer;8(3):167-70; quiz 171. doi: 10.1111/j.1520-037x.2005.3847.x. PMID: 16034220.
Cole CR, Blackstone EH, Pashkow FJ, Snader CE, Lauer MS. Heart-rate recovery immediately after exercise as a predictor of mortality. N Engl J Med. 1999 Oct 28;341(18):1351-7. doi: 10.1056/NEJM199910283411804. PMID: 10536127.
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