Treadmill Exercise Testing May Be Helpful in Predicting Risk of Death From Cardiovascular Disease in

Last Updated: Oct. 1, 2003

Fitness-related variables derived from a treadmill test are useful for predicting a women’s risk for death from cardiovascular disease, according to a study in the September 24, 2003 issue of The Journal of the American Medical Association (JAMA).

Cardiovascular disease claims the life of 1 of every 2 women in the United States, with most sudden deaths in women occurring in those with no previous symptoms, according to background information in the article.

Identifying asymptomatic women who are at increased risk and who may benefit from aggressive primary prevention has the potential to reduce cardiovascular illness and death in women. It is controversial whether exercise testing should be used to screen asymptomatic women for cardiovascular risk.

While several studies have found certain exercise test variables (e.g., reduced exercise capacity and ischemic ST-segment depression [an abnormal measurement on a electrocardiogram]) to be associated with increased mortality in healthy men, it is not known if these have similar predictive value in women.

Samia Mora, M.D., M.H.S., of the Johns Hopkins Medical Institutions, Baltimore, and colleagues investigated the role of exercise treadmill testing in predicting cardiovascular and all-cause death in a group of asymptomatic women. The study included treadmill test data from the Lipid Research Clinics Prevalence Study (1972-1976) with follow-up through 1995. A total of 2,994 asymptomatic North American women, aged 30 to 80 years, without known cardiovascular disease, participated in the study.

During an average follow-up of 20.3 years, there were 427 deaths from any cause, including 147 cardiovascular deaths. Women with high levels of exercise capacity and high heart rate recovery (HRR) (ability of the heart rate to return to normal after peak exercise) had fewer all-cause and cardiovascular deaths during follow-up. They were also younger, reported more regular exercise, and had more favorable clinical and exercise test profiles compared with women who had lower exercise capacity or HRR. Failure to achieve target heart rate and ventricular arrhythmia were also predictors of poor prognosis.

The researchers report that their findings “support the potential use of exercise testing as a risk-stratification tool for primary prevention in asymptomatic women, incremental to the traditional cardiovascular risk factors.”

We Have Answers Do you have medical questions or need help finding a doctor? The experts at Columbia St. Mary's and Advanced Healthcare can help. Click here.