{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T17:41:56Z","timestamp":1769881316770,"version":"3.49.0"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T00:00:00Z","timestamp":1629763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Aims\/Introduction<\/jats:title><jats:p>Several cross\u2010sectional studies have shown that delayed heart rate recovery (HRR) after exercise is associated with the development of metabolic syndrome (MetS). However, there has been a lack of comprehensively designed longitudinal studies. Therefore, our aim was to evaluate the longitudinal association of delayed HRR following a graded exercise treadmill test (GTX) with incident MetS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>This was a retrospective longitudinal cohort study of participants without MetS, diabetes, or cardiovascular diseases. The HRR was calculated as the peak heart rate minus the resting heart rate after a 1 min rest (HRR1), a 2 min rest (HRR2), and a 3 min rest (HRR3). Multivariate Cox proportional hazards analysis was performed to investigate the association between HRR and development of MetS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 676 (31.2%) incident cases of MetS identified during the follow\u2010up period (9,683 person\u2010years). The only statistically significant relationship was between HRR3 and the development of MetS. The hazard ratios (HRs) (95% confidence interval [CI]) of incident MetS comparing the first and second tertiles to the third tertile of HRR3 were 1.492 (1.146\u20131.943) and 1.277 (1.004\u20131.624) with <jats:italic>P<\/jats:italic>\u2009=\u20090.003 after adjustment for multiple risk factors. As a continuous variable, the HR (95% CI) of incident MetS associated with each one\u2010beat decrease in HRR3 was 1.015 (1.005\u20131.026) with <jats:italic>P<\/jats:italic>\u2009=\u20090.004 after full adjustments. An HRR3 value \u226445 beats per minute (bpm) was associated with a higher risk of incident MetS compared with values &gt;45\u2009bpm, with an HR (95% CI) of 1.304 (1.061\u20131.602) and <jats:italic>P<\/jats:italic>\u2009=\u20090.001.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The slow phase of HRR, particularly HRR3, might be more sensitive at predicting the risk of MetS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdi.13637","type":"journal-article","created":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T07:58:10Z","timestamp":1627372690000},"page":"167-176","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Delayed heart rate recovery after exercise predicts development of metabolic syndrome: A retrospective cohort study"],"prefix":"10.1111","volume":"13","author":[{"given":"Tae Yang","family":"Yu","sequence":"first","affiliation":[{"name":"Division of Endocrinology and 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