Heart Health Preventing Heart Problems

The Treadmill Test: Is It a Heart Saver?

Maybe a close relative died of a heart attack at 45 and you are now approaching middle age, or maybe you're starting an exercise program after 10 years of a mostly sedentary lifestyle. Either way, you'll want to know what your risk of heart disease is even if you don't have any symptoms of heart disease, such as chest pain.

Two recently published studies offer new information about whether it's helpful for people without symptoms to get an exercise stress test, where the heart is monitored while you walk or run on a treadmill or ride a stationary bicycle. Although these tests are often given to healthy people, the American Heart Association, the American College of Cardiology and other leading organizations only recommend stress tests for men and women with obvious heart disease because of a lack of evidence that they are useful in the general population.

"We asked whether the exercise test can detect disease at an early stage before it can cause symptoms and when we can do something to prevent trouble," says Michael S. Lauer, a professor of medicine at the Cleveland Clinic Lerner College of Medicine and lead author of one of the studies, published in the September 22th issue of The Journal of the American Medical Association.

Rating Risk Factors
When assessing heart disease risk in their healthy patients, doctors first look at the major risk factors for heart disease such as age, gender, blood pressure, diabetes, cholesterol and smoking status.

"We come up with the patients who are at greatest risk, and then we look at additional risk factors, such as whether or not they're postmenopausal, if they're women, or whether they have high C-reactive protein, which is a marker in the blood believed to reflect an increased risk of heart disease," says Kelly Spratt, DO, an clinical assistant professor at the University of Pennsylvania and a cardiologist in Penn's Cardiovascular Risk Intervention Program.

The Exercise Stress Test
The next step in assessing risk may be an exercise stress test. By looking at your heart under stress, doctors can measure how well the heart works and if there is adequate blood flow to the heart. A poor result may suggest someone has an irregular heartbeat or is out of shape, or that there is blockage in the arteries and that the person has coronary heart disease. If the artery blockage is confirmed with other tests, the person may undergo procedures such as angioplasty, stenting or bypass surgery to treat their heart disease.

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