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Increasing physical activity is weakly associated with lowering resting heart rate over 6 months in COPD patients not taking beta-blockers

In patients with COPD, increasing daily step count over 6 months was inversely associated with changes in resting heart rate (rs = -0.48), LF/HF ratio (rs = -0.35), and SD2/SD1 ratio (rs = -0.28) in those not taking beta-blockers. Changes in movement intensity during walking were also inversely associated with changes in SD2/SD1 ratio (rs = -0.51). Cross-sectional associations between physical activity and cardiac autonomic function were weak to moderate.

Last updated: Aug 27, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. The relation between physical activity and cardiac autonomic dysfunction in patients with chronic obstructive pulmonary disease.

observational

Hermans F, Arents E, Blondeel A, Janssens W, Cardinaels N, Calders P, Troosters T, Derom E, Demeyer H · PloS one (2026)

Participants: N/A
Duration: 6 months
Intervention: 6-month coaching program to increase physical activity (steps per day and movement intensity during walking)
Outcome: Cardiac autonomic function measured via resting heart rate, heart rate variability (SDNN, RMSSD, LF/HF, SD2/SD1) during sleep, heart rate recovery after 6-minute walk test, and COMPASS 31 questionnaire
Effect Size: rs = -0.48 for change in daily step count vs. change in resting heart rate; rs = -0.51 for change in movement intensity vs. change in SD2/SD1 ratio
Population: 36 patients with COPD (69% male, mean age 69 ± 7 years, FEV1 53 ± 13% predicted, 28% taking beta-blockers)

Result:

PubMed: 42640910DOI: 10.1371/journal.pone.0353482

Mechanism Graph

Increased physical activity (steps per day) over 6 months
↓
Reduced resting heart rate and sympathetic/parasympathetic balance (LF/HF, SD2/SD1)
↓
Improved cardiac autonomic function in COPD patients not on beta-blockers
↓
Result: Weak but significant association between more activity and lower resting heart rate

Limitations

  • ⚠Small sample size (n=36) and observational design limit causal inference
  • ⚠Effects were only seen in patients not taking beta-blockers, reducing generalizability
  • ⚠Weak associations may be confounded by disease severity or other unmeasured factors

Frequently Asked Questions

Does increasing physical activity improve heart rate variability in COPD patients?▼

The study found that increasing daily step count was associated with reductions in LF/HF ratio and SD2/SD1 ratio, indicating improved autonomic balance, but only in patients not taking beta-blockers.

What is the effect size of physical activity on resting heart rate?▼

The correlation between change in daily step count and change in resting heart rate was rs = -0.48, indicating a moderate inverse association.

Are the results applicable to all COPD patients?▼

No, the effects were only significant in patients not taking beta-blockers, so results may not apply to those on beta-blockers.

How was cardiac autonomic function measured?▼

Using a Polar H10 sensor to measure resting heart rate and heart rate variability during sleep, heart rate recovery after a 6-minute walk test, and the COMPASS 31 questionnaire.

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References

  1. 1.Hermans F, Arents E, Blondeel A, Janssens W, Cardinaels N, Calders P, Troosters T, Derom E, Demeyer H. "The relation between physical activity and cardiac autonomic dysfunction in patients with chronic obstructive pulmonary disease.." PloS one, 2026. PMID: 42640910 DOI: 10.1371/journal.pone.0353482
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.