For a study, researchers found that in rheumatoid arthritis, cardiac autonomic dysfunction was an early indicator of cardiovascular damage (RA). Previous research had mostly focused on resting evaluations; however, examining heart rate (HR) responses to exercise might give new insight into cardiac autonomic dysfunction in this condition. As a result, researchers wanted to see how patients with RA and healthy controls responded to a maximum graded exercise test during and after it (CONs). It was cross-sectional research in which HR responses during and after a maximum graded exercise test were evaluated in 27 female RA patients and 14 female CONs who were frequency matched by physical activity, age, and BMI. Rheumatoid arthritis patients had a lower HR recovery (HRR) and a lower chronotropic response (94.3% ± 16.3% vs. 106.1% ± 10.3%, p=0.02)  at 30 seconds (8.6 ± 6.7 vs. 13.4 ± 5.2 beats/min [bpm], p=0.02), 60 seconds (16.5 ± 7.8 vs. 24.0 ± 9.9 bpm, p=0.01), 120 seconds (32.6 ± 9.9 vs. 40.7 ± 12.3 bpm, p=0.03)  and 180 seconds (46.5 ± 12.6 vs. 55.5 ± 13.4 bpm, p=0.05). Furthermore, in RA patients, the prevalence of chronotropic incompetence (defined as failure to obtain 80% of the HR-predicted response) and atypical HRR (defined as HRR ≤ 12 bpm) was 22.2% and 37.1%, respectively.

Patients with RA had a slower post-exercise HRR and a worse chronotropic response to exercise. The existence of cardiac autonomic dysfunction and higher cardiovascular risk in this population was indicated by aberrant autonomic responses to exercise.