University of Oulu

Risto Karvonen, Marika Sipola, Antti M. Kiviniemi, Marjaana Tikanmäki, Marjo-Riitta Järvelin, Johan G. Eriksson, Mikko P. Tulppo, Marja Vääräsmäki, Eero Kajantie, Postexercise Heart Rate Recovery in Adults Born Preterm, The Journal of Pediatrics, Volume 214, 2019, Pages 89-95.e3, ISSN 0022-3476,

Postexercise heart rate recovery in adults born preterm

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Author: Karvonen, Risto1,2; Sipola, Marika1,2; Kiviniemi, Antti M.3;
Organizations: 1Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu and Helsinki, Finland
2PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
3Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
4Department of Children and Families, National Institute for Health and Welfare, Oulu and Helsinki, Finland
5Biocenter Oulu, Oulu, Finland
6Unit of Primary Care Unit, Oulu, Finland
7Department of Epidemiology and Biostatistics, Imperial College London, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, London, United Kingdom
8Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
9Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
10Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 5.5 MB)
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Language: English
Published: Elsevier, 2019
Publish Date: 2020-09-04


Objective: To evaluate postexercise heart rate recovery (HRR) in adults born preterm.

Study design: We studied the association between preterm birth and postexercise HRR in 545 adults (267 women) at 23.3 years of age (range 19.9–26.3 years). One hundred three participants were born early preterm (<34 completed weeks), 178 late preterm (34–36), and 264 were full term (control group). HRR was calculated as change in heart rate (HR) 30 seconds and 60 seconds after cessation of submaximal step test and maximum HR slope during the first minute after.

Results: Mean peak HR was 159.5 bpm in the early preterm (P = 0.16 with controls), 157.8 bpm in the late preterm (P = 0.56), and 157.0 bpm in the control group. Mean HRR 30 seconds after exercise was 3.2 bpm (95% CI 1.1–5.2) lower in the early preterm group and 2.1 bpm (0.3–3.8) lower in the late preterm group than the full term controls. Mean 60s HRR was 2.5 (−0.1 to 5.1) lower in the early preterm group and 2.8 bpm (0.6–4.9) lower in the late preterm group. Mean maximum slope after exercise was 0.10 beats/s (0.02–0.17) lower in the early preterm group and 0.06 beats/s (0.00–0.12) lower in the late preterm group.

Conclusions: Our results suggest reduced HRR after exercise in adults born preterm, including those born late preterm. This suggests altered reactivation of the parasympathetic nervous system, which may contribute to cardiovascular risk among adults born preterm.

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Series: Journal of pediatrics
ISSN: 0022-3476
ISSN-E: 1097-6833
ISSN-L: 0022-3476
Volume: 214
Pages: 89 - 95.e3
DOI: 10.1016/j.jpeds.2019.06.056
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
3111 Biomedicine
Funding: The ESTER study was supported by grants from the Academy of Finland (SALVE program for 2009–2012 and grants 127437, 129306, 130326, 134791, and 263924 [to E.K.]); University of Oulu Graduate School (to R.K.); the Doctoral Program for Public Health, University of Tampere (to M.S.); the Emil Aaltonen Foundation (to E.K.); Paulo Foundation and the Finnish Foundation for Cardiovascular Research (to A.K.); the European Commission (Framework 5 award QLG1-CT-2000-001643 and Horizon 2020 award 633595 DynaHealth [to M-R.J.]; Horizon2020 award 733280 RECAP Research on Children and Adults Born Preterm [to E.K.]); the Finnish Foundation for Pediatric Research (to E.K.); the Jalmari and Rauha Ahokas Foundation (to E.K.); the Juho Vainio Foundation (to R.K, E.K., M.T., and M.V); the National Graduate School of Clinical Investigation (to M.T.); the Novo Nordisk Foundation (to E.K. and M.V.); the Signe and Ane Gyllenberg Foundation (to E.K.); the Sigrid Jusélius Foundation (to E.K.); and the Yrjö Jahnsson Foundation (to E.K., M.S., and M.V.). The authors declare no conflicts of interest.
EU Grant Number: (633595) DYNAHEALTH - Understanding the dynamic determinants of glucose homeostasis and social capability to promote Healthy and active aging
Copyright information: © 2019 Elsevier. This manuscript version is made available under the CC-BY-NC-ND 4.0 license