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Exercise Testing Warns
Women of Heart Trouble
A brief exercise test can identify seemingly
problem-free women who are at high risk of heart attack and stroke.
While exercise testing is known
to help single out men at high risk of cardiovascular diseases,
there has been controversy about its value for women.
But a just-published 20-year study
by physicians at Johns Hopkins Medical Institutions finds two
measures of physical performance can spot potential problems in
apparently healthy women.
Those two measures are simple endurance
-- how long a woman can keep walking as the speed of a treadmill
increases -- and the rate at which the heart returns to normal
after the 30 minutes or less of exercise, says a report in the
Sept. 24 issue of the Journal of the American Medical Association.
The study included nearly 3,000
women who had no signs of heart disease and were followed for
two decades. Those who ranked in the bottom quarter of the test
results were 3.5 times more likely to suffer a cardiovascular
death than those in the upper half, say Dr. Roger S. Blumenthal
and colleagues at the Hopkins Ciccarone Preventive Cardiology
Center.
Does the study mean every woman
should have an exercise test as part of her physical examination?
Blumenthal, who is director of preventive cardiology at Hopkins,
stops short of that.
"Our study suggests that an
exercise test can provide a good prospective into the cardiovascular
risk of women whose capacity is below normal or who have a slow
return rate," he says. "This should be a consideration,
but it is still up to the individual doctor to determine whether
an exercise test should be done."
The message for women, he says,
is that "they have to realize that if they have a low level
of physical capacity, they can improve their performance and improve
their cardiovascular health with regular exercise."
Dr. Nieca Goldberg is chief of
women's cardiovascular care at Lenox Hill Hospital in New York
City and a spokeswoman for the American Heart Association. She
says, "There has been a lot of controversy about the value
of exercise testing in women. Not until this week has there been
convincing evidence about its value."
"We are always looking for
things that tell about heart risk in women. This test is readily
available and cost-effective," she says.
The American Heart Association
and other health organizations have been trying to get women to
pay more attention to the risk of cardiovascular disease, the
leading cause of death in American women and men.
Women who should have an exercise
test include those with heart disease. But so should symptom-free
women "who have multiple risk factors, such as obesity, smoking
or diabetes, those who are totally sedentary and are over 50,
and those who are thinking of starting an exercise program,"
Goldberg says.
Poor results on the exercise test
should prompt a woman to start a program of regular exercise,
under a doctor's supervision. And they should also serve as a
warning sign that "it is time to start paying attention to
all the risk factors, keeping blood pressure under control, lowering
cholesterol and not smoking," Goldberg says.
A brisk half-hour walk every day
can be enough to promote heart health for most people, cardiologists
say.
More information
The American
Heart Association and the National
Heart, Lung, and Blood Institute have more on the benefits
of exercise.
Reference
Source 101
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