South Asian or Afro-Caribbean ethnicity is not associated with altered 1 min heart rate recovery estimates in suspected coronary artery disease patients

Heart rate recovery following a Bruce exercise protocol provides prognostic information on survival. We investigated the impact of ethnicity on HRR in 271 consecutive patients being assessed for CAD in three main ethnic groups (Caucasian (C); South Asian (SA); Afro-Caribbean (AC)). Our sample contained greater referral of younger, male South Asian subjects than would be expected on the basis of census data. The AC group had a low frequency of typical ischaemic pain. The SA sub-group, despite greater prevalence of diabetes, had marginally better HRR and a more preserved response to exercise. Multiple regression analysis revealed that age and not ethnicity was the main independent predictor of HRR (p = 0.007) with all three ethnic sub-groups having a similar range of exercise time. There was no evidence of under referral of ethnic minorities. Ethnic effects in raw HRR data are most likely confounded by age.