The human heart is the drum of vitality — and its cadence is a key indicator of our overall well-being.
New data has revealed which US states are working out the most and the least — and how those activity levels correlate to heart health.
The World Health Organization recommends 150 minutes of moderate-intensity exercise and two days of strength training per week.
The Centers for Disease Control and Prevention also suggests 150 minutes, but spread over five days.
The Apple Heart and Movement Study tracked metrics such as cardio fitness to better understand how movement influences heart health and what measures can be taken to protect our tickers.
Analyzing data from more than 100,000 Apple Watch users, researchers found people in DC, New York, Massachusetts, Washington, California, Colorado and Vermont are among the most active, while those living in Mississippi, Louisiana, Oklahoma, Arkansas and West Virginia are the least active.
Active individuals generally have lower resting heart rates (RHRs) than sedentary people.
Inside resting heart rates
As the name implies, RHR reflects the number of times per minute your heart beats while awake and at rest.
The American Heart Association says a normal resting heart rate for adults is generally 60 to 100 beats per minute (bpm).
RHR is a primary measure of overall fitness and heart health — a high RHR indicates stress, a low fitness level and increased cardiovascular risk, while a lower RHR is associated with better cardiovascular health and a decreased risk of heart disease.
Heart disease is the leading cause of death in the US, and the condition is on the rise among adults under 40, with rates more than doubling since 2010.
The study revealed that states with the lowest average RHRs included Vermont (61.4 bpm) and Massachusetts (61.4 bpm) — both were also among the most physically active, seemingly confirming other research that suggests that the more you move, the longer and better your life will be.
The least active states, like West Virginia (66.4 bpm), Mississippi (66.4 bpm) and Arkansas (65.5 bpm), conversely reported the highest average RHRs.
Unsurprisingly, heart disease rates are particularly high in these low-activity/high-RHR states.
However, experts note that even these elevated RHR figures are still within the normal range.
Interestingly, Hawaii (60.2 bpm) reported the lowest average RHR, despite not being among the 10 most active states.
The study authors posit that differences in RHR across states can be attributed to regional activity levels, age, diet, stress levels and healthcare accessibility. They note that an expanded understanding of these differences could inform future intervention strategies.
These states are hitting the max
The study also included data on VO2 max, short for maximal oxygen consumption, which determines how much oxygen the body can access during intense exercise.
Also referred to as cardiovascular fitness, VO2 max is measured in milliliters of oxygen per kilogram of body weight per minute (mL/kg/min).
A key marker of well-being, the higher an individual’s VO2 max, the better their overall fitness, endurance and heart health.
Fittingly, the study showed that VO2 max scores were higher in more active states: DC (37.4 mL/kg/min), California (36.4 mL/kg/min) and Massachusetts (36.3 mL/kg/min) had the highest average scores.
The inverse also proved true, with West Virginia (32.9 mL/kg/min), Louisiana (32.9), Mississippi (33.3 mL/kg/min) and Arkansas (33.8 mL/kg/min) recording the lowest averages.
Hawaii (36.5 mL/kg/min) was once again shown to be an outlier, ranking high for VO2 max while falling below the top tier for physical activity.
Age is commonly associated with a decline in VO2 max across gender lines and is regarded as a natural part of the aging process.
Still, experts maintain that regular physical activity, particularly aerobic exercise that increases heart rate, can slow cardiovascular decline as we age and may reduce the risk of heart disease and death.
The American Heart Association warns that 61% of American adults will likely have some type of cardiovascular disease in the next 30 years, as high blood pressure, diabetes and obesity become more common.
Study authors note that the VO2 disparity between states is likely a reflection of differences in weather, lifestyle and/or accessibility of parks and recreational facilities.
They are hopeful that their findings will inform and support initiatives that promote physical activity across communities and state lines.