What is my maximum predicted heart rate?

Maximum Predicted Heart Rate

The most widely recommended formula for estimating maximum predicted heart rate is 220 minus your age in years, though this formula has significant limitations with a standard deviation of ±10-15 beats per minute. 1

Standard Prediction Formula

• The traditional equation is: 220 - age (in years) 2
• This formula applies equally to both males and females according to American Heart Association guidelines 2
• However, the 220-age formula lacks strong scientific basis and has been shown to overestimate peak heart rate by approximately 11-12 bpm in clinical populations 1, 3

Alternative and More Accurate Formulas

More recent evidence suggests alternative formulas may provide better accuracy:

• Tanaka equation: 208 - (0.7 × age) - This formula was derived from meta-analysis of 18,712 subjects and provides more accurate predictions, particularly in older adults 4
• Sex-specific formulas from clinical populations:
  • Women: 197 - (0.8 × age) 3
  • Men: 204 - (0.9 × age) 3
• For physically active populations: 202.5 - (0.53 × age) may be more appropriate 5

Critical Limitations to Understand

The inherent variability in maximum heart rate prediction is substantial and clinically significant:

• All prediction equations have a standard deviation of 10-15 beats per minute within any age group 1
• The traditional 220-age formula tends to underestimate maximum heart rate in older adults and overestimate in younger individuals 5, 4
• Age alone explains only 19-22% of the variance in maximum heart rate, even when combined with fitness level, body composition, and testing modality 5
• Exercise tests should be terminated based on signs and symptoms rather than achievement of a predetermined percentage of predicted maximum heart rate 1

Factors That Affect Maximum Heart Rate

Several clinical factors significantly alter the accuracy of predicted maximum heart rate:

• Medications: Beta-blockers and other cardioactive medications substantially reduce both the incremental rise and maximum heart rate achieved 1, 2
• Disease states: Patients with cardiac disease show even greater heart rate variation than the standard ±10-12 bpm error 1
• Fitness level: Aerobic capacity influences heart rate response, though it does not substantially improve prediction accuracy 5, 4
• Testing modality: Treadmill protocols typically yield higher maximum heart rates (up to 20% higher) compared to cycle ergometer testing 1

Clinical Application

For practical purposes in clinical settings:

• Use 220 - age as a general estimate, recognizing its significant limitations 2
• Consider the Tanaka formula (208 - 0.7 × age) for more accurate predictions, especially in older adults 4
• Never use predicted maximum heart rate as a strict endpoint for exercise testing - instead, terminate based on clinical signs, symptoms, ECG changes, blood pressure response, or oxygen desaturation 1, 2
• For submaximal testing, target 85% of age-predicted maximum heart rate, but recognize this overestimates volitional effort 1
• The most accurate determination of maximum heart rate requires direct measurement during a graded maximal exercise test lasting 8-12 minutes 1