Does resting heart rate measured by the physician reflect the patient’s true resting heart rate? White-coat heart rate

Lequeux, Benoît; Uzan, Charles; Rehman, Michaela B.

doi:10.1016/j.ihj.2017.07.015

Cited by 13 publications

(10 citation statements)

References 15 publications

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“…1–5,10 However, previous studies have shown that HRs measured in clinical settings may not be representative of real-world HR and may be biased by the particular clinical conditions for which the ECGs were ordered. 1,3 For example, a “white-coat” effect can increase HR, 11 leading to false elevation. Furthermore, ambulatory, real-world HR, has been found to correlate significantly more with mortality than resting heart rate obtained in the clinical setting, 12 suggesting the need to update HR norms to reflect real-world, remotely obtained values.…”

Section: Discussionmentioning

confidence: 99%

“…2 Whereas our 95th percentile was similar among those < 40 years old (104 bpm in both cohorts), among those > 40 years old, we found a lower 95th percentile (100 bpm vs 104 bpm), 2 which may be due to our repeat measurements taken outside of the clinic setting, decreasing variability, and minimizing any “white-coat” heart rate effect. 11 Furthermore, we described the circadian evolution of real-world HR, which allows us to interpret these values according to the time of day. 13 We observed that HR-PPG and HRV levels decline with age.…”

Section: Discussionmentioning

confidence: 99%

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Real-world heart rate norms in the Health eHeart study

et al. 2019

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Emerging technology allows patients to measure and record their heart rate (HR) remotely by photoplethysmography (PPG) using smart devices like smartphones. However, the validity and expected distribution of such measurements are unclear, making it difficult for physicians to help patients interpret real-world, remote and on-demand HR measurements. Our goal was to validate HR-PPG, measured using a smartphone app, against HR-electrocardiogram (ECG) measurements and describe out-of-clinic, real-world, HR-PPG values according to age, demographics, body mass index, physical activity level, and disease. To validate the measurements, we obtained simultaneous HR-PPG and HR-ECG in 50 consecutive patients at our cardiology clinic. We then used data from participants enrolled in the Health eHeart cohort between 1 April 2014 and 30 April 2018 to derive real-world norms of HR-PPG according to demographics and medical conditions. HR-PPG and HR-ECG were highly correlated (Intraclass correlation = 0.90). A total of 66,788 Health eHeart Study participants contributed 3,144,332 HR-PPG measurements. The mean real-world HR was 79.1 bpm ± 14.5. The 95th percentile of real-world HR was ≤110 in individuals aged 18–45, ≤100 in those aged 45–60 and ≤95 bpm in individuals older than 60 years old. In multivariable linear regression, the number of medical conditions, female gender, increasing body mass index, and being Hispanic was associated with an increased HR, whereas increasing age was associated with a reduced HR. Our study provides the largest real-world norms for remotely obtained, real-world HR according to various strata and they may help physicians interpret and engage with patients presenting such data.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Real-world heart rate norms in the Health eHeart study

et al. 2019

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“…The second one refers to the caution which should be used in the interpretation of data since the %HRR metric was based on the commonly accepted formula for estimating the maximum heart rate, which has its own limitations [33]. Also, an ambulatory trial found heart rates at rest lower when self-measured at home compared to those measured under expert observation [34]. Obviously, such an effect will probably lead to an underestimation of job’s difficulty, the same way the exposure to high thermal stress will.…”

Section: Discussionmentioning

confidence: 99%

Manual Cultivation Operations in Poplar Stands: A Characterization of Job Difficulty and Risks of Health Impairment

Marogel-Popa

Cheţa

Marcu

et al. 2019

IJERPH

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Short rotation poplar forests are a viable alternative in producing high quality wood for industrial applications. Their success depends on timely and high-quality implementation of a series of operations. Weed control operations are implemented to favor the trees in their competition for soil resources, and cultivation is an option typically used in many European countries. For the moment, a complete mechanization of such operations is virtually impossible, and they still require an intensive use of manual labor. Since information on work difficulty and risks in manual cultivation operations is limited, this study aimed to characterize this job. Evaluation was made in terms of work efficiency, cardiovascular workload, work intensity and postural risks by implementing a time and motion study combined with heart rate measurements, accelerometry and whole-body postural analysis. Work efficiency was particularly low even if the share of effective work time was high (70% of the observation time). Job was characterized as moderate to high intensity, which resulted into a moderate to high cardiovascular strain. While the postural analysis indicated rather small risks, the main problem was found for the back postures assumed during the work. Improvements should aim to extend mechanization, train the workers and appropriately design rest breaks.

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“…Future studies should invest in validating predictions for stroke survivors. Furthermore, physiological resting values were measured pre-exercise, possibly causing excitement or stress (similar to a white-coat effect 53 ), slightly overestimating true resting values and underestimating percentages of heart rate reserve.…”

Section: Discussionmentioning

confidence: 99%

Physiological Responses and Perceived Exertion During Robot-Assisted and Body Weight–Supported Gait After Stroke

Lefeber

Keersmaecker

Henderix

et al. 2018

Neurorehabil Neural Repair

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Does resting heart rate measured by the physician reflect the patient’s true resting heart rate? White-coat heart rate

Abstract: Our study brings to light an exciting idea that could have a major therapeutic and maybe prognostic impact in cardiology: resting HR measured by the physician in consultation does not reflect true resting HR. This must be taken into account to adapt treatment.

Cited by 13 publications

References 15 publications

Real-world heart rate norms in the Health eHeart study

Real-world heart rate norms in the Health eHeart study

Manual Cultivation Operations in Poplar Stands: A Characterization of Job Difficulty and Risks of Health Impairment

Physiological Responses and Perceived Exertion During Robot-Assisted and Body Weight–Supported Gait After Stroke

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