Sex-Specific Maximum Predicted Heart Rate and Its Prognosis for Mortality and Myocardial Infarction

Purpose: Maximum predicted heart rate (MPHR) is traditionally calculated by (220 − age). However, this formula's validity has been questioned in women. The purpose of this study was to derive sex-specific formulas for MPHR in a clinical population and compare their prognostic significance with the traditional formula. Methods: This was a retrospective cohort of adults referred for exercise treadmill testing between 1991 and 2009. Peak heart rate versus age was plotted by sex, and linear regression analysis was used to derive sex-specific MPHR formulas. Cox models were used to calculate risk of death and myocardial infarction (MI) based on attainment of 85% MPHR using both formulas. Results: Of 31,090 patients (mean ± SD, age = 55 ± 10 yr), there were 2824 deaths over 11 ± 5 yr. MPHR was best estimated by 197 − 0.8 × age for women and 204 − 0.9 × age for men (P interaction

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