Poor heart rate recovery is associated with which of the following?

• A. Ischemic heart disease mortality
• B. Improved endurance
• C. Decreased blood pressure
• D. Increased muscle strength

Answer: (A)

Heart rate recovery after stopping exercise reflects how quickly the body reactivates the parasympathetic branch of the autonomic nervous system. A fast decline in heart rate is a sign of good autonomic balance and cardiovascular fitness, while a slow or blunted decline indicates autonomic dysfunction with sustained sympathetic activity. This slower recovery has been consistently linked to a higher risk of adverse cardiovascular outcomes, including mortality from ischemic heart disease. In other words, poor heart rate recovery acts as a prognostic marker signaling greater risk for ischemic heart disease–related death, independent of other risk factors. The other options don’t fit as well because improved endurance, decreased blood pressure, or increased muscle strength don’t directly reflect the autonomic dysfunction that poor HRR indicates, and are not the specific associated risk outcome described by studies on HRR.