Heart rate recovery under healthy aging or age-related pathologies

Abstract

The interpretation of heart rate recovery (HRR) in aging presents a paradox: while it is a powerful predictor of mortality in disease states, its decline is not an inevitable consequence of healthy aging. This narrative review critically synthesizes evidence to resolve this paradox by delineating the distinct trajectories of HRR across the aging spectrum. Age alone does not impair HRR following exercise stress. Training status emerges as a more significant determinant of HRR than age. Moreover, HRR following cognitive challenge appears to be preserved with age. Better post-stress HRR predicts superior memory performance in older adults. We conclude that HRR serves not as a simple biomarker of chronological age, but as an integrative marker of physiological reserve, with its prognostic power becoming paramount in the context of age-related disease, and its modifiability offering a key target for interventions.

Key words: Heart rate recovery, autonomic regulation, cardiovascular aging