Prediction of Maximal Heart Rate in Children and Adolescents

To identify a method to predict the maximal heart rate (MHR) in children and adolescents, as available prediction equations developed for adults have a low accuracy in children. We hypothesized that MHR may be influenced by resting heart rate, anthropometric factors, or fitness level.Cross-sectional study.Sports medicine center in primary care.Data from 627 treadmill maximal exercise tests performed by 433 pediatric athletes (age 13.7 ± 2.1 years, 70% males) were analyzed.Age, sex, sport type, stature, body mass, BMI, body fat, fitness level, resting, and MHR were recorded.To develop a prediction equation for MHR in youth, using stepwise multivariate linear regression and linear mixed model. To determine correlations between existing prediction equations and pediatric MHR.Observed MHR was 197 ± 8.6 b·min. Regression analysis revealed that resting heart rate, fitness, body mass, and fat percent were predictors of MHR (R = 0.25, P < 0.001), whereas age was not. Resting heart rate explained 15.6% of MHR variance, body mass added 5.7%, fat percent added 2.4%, and fitness added 1.2%. Existing adult equations had low correlations with observed MHR in children and adolescents (r = -0.03-0.34).A new equation to predict MHR in children and adolescents was developed, but was found to have low predictive ability, a finding similar to adult equations applied to children.Considering the narrow range of MHR in youth, we propose using 197 b·min as the mean MHR in children and adolescents, with 180 b·min the minimal threshold value (-2 standard deviations).