August 9, 2005

Exercise Test Spots Trouble Ahead for Healthy Men

NEW YORK -- While apparently healthy men don't routinely undergo exercise stress testing, it may be useful for raising a red flag about impending health problems, Norwegian investigators report based on a study of middle-age men.

Exercise stress tests are usually reserved for assessing cases of suspected heart disease. However, the new study shows that men who seem healthy but who terminate an exercise test only because they have trouble breathing actually have a high long-term risk of dying early from heart disease or lung disease.

For the study, 2014 men between 40 and 59 years old took a bicycle exercise test and were followed for an average of 26 years.

Compared with men who stopped the test due to exhaustion, the 178 men who stopped exclusively for breathing difficulties had an 86 percent greater risk of dying from coronary heart disease during follow-up. They were also 3-1/2 times more likely to die from pulmonary causes.

"Thus, impaired breathing as the main reason for having to stop an exercise test was an ominous finding when not part of an 'exhaustion syndrome'," Dr. Johan Bodegard and colleagues from the University of Oslo write in the European Heart Journal.

They note that exercise testing has recently been suggested not only for people with probable heart disease but also to screen apparently healthy subjects -- and the author of a related editorial thinks this is a good idea.

Dr. Victor F. Froelicher from the Palo Alto VA Medical Center in California contends that "there is now sufficient evidence for recommending a routine exercise test every 5 years" for symptomless men older than 40 and women older than 50 years of age.

"Given the emerging epidemic of physical inactivity, inclusion of the exercise test in the screening process sends a strong message to our patients, that we consider their exercise status as important," Froelicher writes.

SOURCE: European Heart Journal, July 2005.