Which estimated maximum heart rate formula is used for clients with high blood pressure

Q I know three ways of calculating maximum heart rate (MHR): 220 – age; 214 – (0.8 x age); and 205 – 1/2 age. For a 30-year-old, they all come out at 190, but for a 60-year-old, the results are 160, 166 and 174 – a large range. Which is the most accurate?

A In general terms, at the start of your 20s, the MHR is about 200 beats per minute (BPM). From then on, the heart gradually slows down, by approximately one beat per year. In endurance athletes, the MHR also slows as a response to prolonged training. Essentially, as it is trained the heart becomes more efficient and therefore slower. Added to this is the natural variation of all of us – the “normal distribution” – of height, weight, blood pressure, MHR and so on. The majority of us are in the middle as “average”, but many lie on either side. Thus some people have a naturally lower MHR and others have a higher one. Formulae can’t legislate for that.

By far the best way to calculate your own rate is to exert yourself as hard as you can, say in a 10-minute hard run, on a reasonably warm day, with a 400m sprint finish, and count your pulse rate for 20 seconds from the very instant you stop running. Multiply that by three, and to whatever value that gives you I would add five BPM, and that can be taken as your “best estimate” of MHR. If you repeat it, and it differs, take the higher value.

Of the various accepted formulae you mention, the one that seems to accord best with “genuine” MHR is 220 – age, but even this is unreliable; it’s best to find out on your own by testing your actual heart rate.

—Professor Craig Sharp, exercise physiologist, Brunel University

Important to get the maximum heart rate right

Maximum heart rate (HRmax) is an important tool to uncover cardiovascular disease. During stress testing, age-expected maximum heart rate is used as a guideline for when the test should be concluded. If the test is finished before the load is high enough, you risk not to detect subclinical heart disease. Therefore, it is of great clinical relevance to have a way to accurately estimate HRmax.

The traditional formula for determining HRmax is "220 minus age", but can underestimate HRmax by up to 40 beats per minute in seniors. In fact, the method is inaccurate already at an age of 30–40 years, and gets more inaccurate the older you are.

In The HUNT Fitness Study, we measured accurate maximum heart rate in 3,320 healthy adults aged between 19 and 89. Based on these tests we made a completely new formula which estimates maximum heart rate far more accurately than "220 minus age". The HRmax Calculator is based on this formula: "211 - 0.64*age".

Read the full article:
Age-predicted maximal heart rate in healthy subjects: The HUNT Fitness Study

Maximum heart rate and beta blockers

Our HRmax Calculator asks you to check a box if you use beta blockers. The reason for that is that heart patients and others on beta blockers will have a reduced maximum heart rate.

Beta blockers bind to adrenaline receptors and block access for adrenaline molecules. Adrenaline causes the heart to pump both harder and faster. Hence, beta blockers reduce the maximum heart rate. The magnitude of the reduction depends on the dosage, so we recommend that you test yourself to find an exact HRmax.

Find your exact maximum heart rate

Our research shows that the variation in maximum heart rate within age groups is fairly large. Genetics contribute more to maximum heart rate than physical fitness. Therefore, it's hard to make a calculator that can estimate maximum heart rate precisely, and we recommend all of you who want to find your real HRmax to test yourself by pushing yourself to exhaustion:

1. Warm up thoroughly so you start sweating.
2. Do two intervals, each four minutes long. During the intervals you should be too short of breath to talk. Intersperse each interval with three minutes of active rest.
3. Start the third interval, but two minutes in, increase your speed even further an run until you're too exhausted to continue. Your HRmax will be the highest heart rate you reach. The heart will reach a plateau at which it cannot beat any faster, regardless of how much you increase the workload.

If you don't have a heart rate monitor, you can measure the maximum heart rate by holding two fingers to your neck for 30 seconds right after finishing the test. Double the number you get to find your HRmax.

Maximum heart rate and exercise

During 4x4 interval training, you use your maximum heart rate to give the heart good exercise. Our HRmax Calculator calculates at which heart rate you should exercise when performing this kind of interval training. The 4x4 principle can be used in a variety of activites, including running, biking, swimming and rowing.

1. Start with a ten minute warm-up at approximately 60 % of HRmax to get you sweating.
2. Do four intervals, each four minutes long. The last two minutes of each interval your heart rate should be at 90–95 % of HRmax, so you become short of breath. Use the first two minutes of each interval to reach this heart rate level.
3. Between each interval, your should perform active resting at a heart rate of approximately 70 % of HRmax. This is the zone where the body clears lactic acid most efficiently.
4. End with a ten minute cool-down with lighter activity after the last interval.

Watch our video for further explanation on how to perform effective 4x4 interval training:

Frequently Asked Questions

Your maximum heart rate is the highest number of beats your heart can manage in one minute.

Your maximum heart rate could help you exercise more efficiently. During interval training, for instance, it is useful to know in which pulse zone your heart benefits the most from exercise. Read more.

It is also clinically relevant to find the right maximum heart rate to detect hidden cardiovacular disease during an exercise stress test. Read more.

The traditional method by subtracting age from 220 to find maximum heart rate is less accurate than our HRmax Calculator. For older persons using "220 minus age" the estimated maximum heart rate could miss by 40 beats! Read more.

The variation in maximum heart rate within age groups is fairly large. Therefore, it's hard to make a calculator that can estimate maximum heart rate precisely, and we recommend to test yourself with an exercise test to find your real HRmax. Read more.

No, your HRmax is not related to your physical fitness. An exercised heart pumps more blood each beat, but not faster than untrained hearts.

Genes and age are the two factors that influence maximum heart rate the most, in addition to medication that affects the heart rhythm. Our research shows that neither gender, smoking nor BMI influences HRmax. Neither does how much you exercise nor your physical capacity.

Gender has very limited influence on maximum heart rate, but men seem to have marginally higher HRmax than women. That's why gender is included in our calculator.

The HRmax Calculator also includes a BMI calculator. Body weight and height are not part of the formula that estimates your maximum heart rate, but is used to calculate BMI. Values between 18 and 25 are considered normal body weight.

Beta blockers are medication used for diseases like heart failure, angina and hypertension. Beta blockers inhibit the action of adrenaline, and will therefore lower the heart rate. Read more.

Fitness Calculator

Higher maximum heart rate with lower fitness

Healthy non-athletes almost reach their true maximum heart rate during an all-out test of maximum oxygen uptake. In our research, we usually add five heart beats to the highest heart rate achieved during a cardiopulmonary exercise test, but according to our new results that is three beats too many. The study also indicates that women and men have similar maximum heart rates, and that persons with below-average fitness generally have higher maximum heart rates than fitter persons.

The study includes 107 men and women between 22 and 70 years of age. They all had their maximum oxygen uptake tested at our lab, and then performed a standardized maximum heart rate test a few days later. The results show that the real maximum heart rate was 2.2 beats higher per minute than the maximum heart rate achieved during the test of oxygen uptake.

Read the full research article in Journal of Science and Medicine in Sport:
The relationship between maximum heart rate in a cardiorespiratory fitness test and in a maximum heart rate test

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