Re-Visiting Maximal Heart Rate Prediction Using Cross-Validation in Population Aged 7–55 Years

Abstract

The primary purpose of the present study was to re-visit HRmax prediction by two commonly used equations (i.e., Fox′s and Tanaka′s equation) compared to the direct measured HRmax using the large sample size of Asians. The second aim of the study was to focus on suggesting new equations for the Asian population by separating gender and specific age groups. A total of 672 participants aged from 7 to 55 years were recruited for the study (male: 280 and female: 392), and the maximal graded exercise test with Bruce protocol was used to measure HRmax. All data obtained from the study were analyzed by SPSS 25.0. Additionally, three statistical analysis methods (i.e., Mean Absolute Percent Errors (MAPE), Bland–Altman plots, and equivalence testing) were utilized to confirm the consistency between the measured HRmax and the two prediction equations. The main finding was that two equations showed significant differences in predicting the HRmax of Korean aged from 7 to 55 years. The outcome of children aged from 7 to 14 was a different fit in the agreement compared to other age groups. Fox′s equation had the best fit in the average of the difference closer to zero and completely included within the equivalence zone, but females over 15 years old revealed higher errors than males in the values calculated by the two equations compared to the direct measured HRmax. Consequently, the study demonstrated that both equations tended to overestimate the HRmax for males and females over 15 years old, and the two universal equations were not suitable to predict the HRmax of Koreans except for children aged from 7 to 14 years. The new HRmax prediction equations suggested in this study will more accurately predict the HRmax of Asians, and additional analyses should be examined the cross-validity of the developed HRmax equation by age and gender in the future study.