Increasing the amount of physical activity showed a weak relation with lowering resting heart rate over 6 months in patients with COPD not taking influencing medication.
Key Findings
Results
Cross-sectional analyses showed weak to moderate associations between heart rate recovery and movement intensity during walking and exercise capacity in COPD patients.
Heart rate recovery was associated with movement intensity during walking (rs = 0.45)
Heart rate recovery was associated with distance covered during the 6-minute walking test (rs = 0.55)
These associations were characterized as 'weak to moderate' by the authors
Sample included 36 patients with COPD (69% male, mean age 69 ± 7 years, FEV1 53 ± 13% predicted)
Results
Longitudinal changes in daily step count were inversely associated with changes in resting heart rate, LF/HF ratio, and SD2/SD1 ratio in patients not taking β-blockers.
Changes in daily step count were inversely associated with changes in resting heart rate (rs = -0.48)
Changes in daily step count were inversely associated with changes in LF/HF ratio (rs = -0.35)
Changes in daily step count were inversely associated with changes in SD2/SD1 ratio (rs = -0.28)
These associations were only observed in patients not taking β-blockers (28% of the total sample were taking β-blockers)
Follow-up period was 6 months using a coaching program
Results
Changes in movement intensity during walking were inversely associated with changes in the SD2/SD1 ratio over 6 months in patients not taking β-blockers.
The inverse association between movement intensity during walking and SD2/SD1 ratio had a correlation of rs = -0.51
This was the strongest longitudinal association observed in the study
SD2/SD1 ratio is a heart rate variability parameter reflecting sympathovagal balance
This finding was restricted to patients not taking β-blockers
Methods
Cardiac autonomic function was assessed using both objective sensor-based measures and a subjective questionnaire at baseline and 6-month follow-up.
Objective measures included resting heart rate during sleep, heart rate variability during sleep (SDNN, RMSSD, LF/HF ratio, SD2/SD1 ratio), and heart rate recovery following the 6-minute walking test (6MWT), all measured using the Polar H10 sensor
Subjective autonomic function was assessed using the COMPASS 31 questionnaire
Physical activity was measured using accelerometry, capturing steps per day and movement intensity during walking
Assessments were conducted at baseline and at 6-months follow-up
Methods
The study population consisted of 36 COPD patients with moderate airflow obstruction, with a substantial proportion taking β-blockers.
Sample size was 36 patients with COPD
69% were male, mean age 69 ± 7 years
Mean FEV1 was 53 ± 13% predicted, indicating moderate airflow obstruction on average
28% of patients were taking β-blockers, which influenced autonomic function analyses and required subgroup separation
Background
Exercise training is known to improve cardiac autonomic function in COPD, but the effects of changing physical activity (distinct from structured exercise training) on cardiac autonomic function were previously unknown.
The authors distinguish between exercise training and physical activity as separate constructs
Cardiac autonomic dysfunction is described as 'common in patients with chronic obstructive pulmonary disease (COPD)'
The study aimed to fill the gap in knowledge about whether changes in everyday physical activity relate to changes in cardiac autonomic function
A 6-month coaching program was used to promote physical activity change rather than a structured exercise intervention
What This Means
This research examined whether the amount of daily physical activity is linked to heart rate control in people with chronic obstructive pulmonary disease (COPD), a condition affecting the lungs. The heart's ability to regulate its own rhythm—known as cardiac autonomic function—is often impaired in COPD patients. While structured exercise programs are known to help, it was unclear whether simply being more active in daily life would have similar benefits. The study measured heart rate patterns during sleep and after a walking test in 36 COPD patients, alongside tracking their steps and walking intensity using activity monitors, both at the start and after a 6-month activity coaching program.
The study found that at baseline, patients who walked with more intensity and covered greater distances in a walking test tended to have better heart rate recovery after exercise—a sign of healthier cardiac autonomic function. Over the 6-month period, patients who increased their daily step count (and who were not taking beta-blocker medications that affect heart rate) tended to show decreases in resting heart rate and improvements in certain measures of heart rate variability. The associations were described as weak to moderate in strength, meaning physical activity explained only part of the variation in cardiac autonomic function.
This research suggests that becoming more physically active in everyday life—not just through formal exercise—may have modest beneficial effects on heart rate regulation in people with COPD, particularly for those not on certain heart medications. However, because the associations were relatively weak and the sample size was small (36 patients), these findings should be interpreted cautiously. Future larger studies are needed to confirm whether increasing daily activity is a meaningful strategy for improving cardiac health in COPD patients.
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Hermans F, Arents E, Blondeel A, Janssens W, Cardinaels N, Calders P, et al.. (2026). The relation between physical activity and cardiac autonomic dysfunction in patients with chronic obstructive pulmonary disease.. PloS one. https://doi.org/10.1371/journal.pone.0353482