The Impact of Intense Exercise on Average Heart Rate and Cardiovascular Benefit

Article Impact Level: HIGH
Data Quality: STRONG
Summary of JACC: Advances, https://doi.org/10.1016/j.jacadv.2025.102140 
Dr. Tim Van Puyvelde  et al.

Points

The study investigated “heartbeat consumption” in 109 athletes and 38 controls using 24-hour Holter monitoring.
Athletes exhibited a significantly lower average 24-hour heart rate (68 ± 11 beats/min) compared to controls (76 ± 8 beats/min, P < 0.001).
This difference was primarily due to lower resting heart rates in athletes, offsetting exercise-induced increases.
The reduced average heart rate resulted in 11,520 or 10.6% fewer heartbeats over 24 hours for athletes.
The concept of “heartbeat consumption” is introduced as a metric for training load and potential adverse effects of intense exercise.

Summary

This exploratory analysis investigated the concept of “heartbeat consumption” in elite cyclists, examining the balance between exercise-induced heart rate increases and long-term reductions in resting heart rate. While high volumes of intense exercise training raise concerns about potential health implications, regular exercise is known to lower resting heart rates, a factor associated with reduced cardiovascular risk. The study aimed to quantify this relationship by analyzing 24-hour heart rate data in athletes versus healthy controls, considering the hypothesis that a “fixed number of heartbeats” might dictate lifespan across species.

The study included 109 athletes and 38 healthy controls from the Australian cohort of the Prospective Athletic Heart (Pro@Heart) study. Participants wore 24-hour Holter monitors during normal activities and exercise training. Athletes were slightly younger (median 19 years [17-22] vs. 21 years [19-22]; P = 0.001), but the sex ratio was similar (69.6% male in athletes vs. 68.4% in controls; P = 0.888). Holter recordings demonstrated excellent accuracy, with non-diagnostic data at 1.1% [0.0%-3.6%] for athletes and 1.6% [0.6%-2.8%] for controls (P = 0.123).

A main finding was that the average 24-hour heart rate was significantly lower in athletes (68 ± 11 beats/min) compared to controls (76 ± 8 beats/min; P < 0.001). This difference was consistent across sexes and primarily attributed to lower resting heart rates in athletes, as evidenced by a leftward shift in heart rate histograms. The percentage of heart rates ≥100 bpm was similar (7.6% [2.7%-12.2%] for athletes vs. 9.4% [3.9%-13.9%] for controls; P = 0.115). Crucially, the reduced average heart rate in athletes resulted in 11,520, or 10.6%, fewer heartbeats over a 24-hour period, suggesting a potential long-term cardiovascular benefit despite acute exertional increases.

Link to the article: https://www.jacc.org/doi/10.1016/j.jacadv.2025.102140

References

Van Puyvelde, T., Janssens, K., Spencer, L., D’Ambrosio, P., Ray, M., Foulkes, S. J., Haykowsky, M. J., Claessen, G., Willems, R., & La Gerche, A. (2025). Balancing exercise benefits against heartbeat consumption in elite cyclists. JACC: Advances, 4(10), 102140. https://doi.org/10.1016/j.jacadv.2025.102140