Responses to maximal exercise in healthy middle-aged women.

Profant, Gene R.; Early, Ronald G.; Nilson, Karen; Kusumi, Fusako; Hofer, Verona; Bruce, Robert A.

doi:10.1152/jappl.1972.33.5.595

Cited by 77 publications

(20 citation statements)

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“…All of these studies in women suggest that the traditional age-predicted maximal HR overestimates the peak HR in younger women and underestimates the predicted peak HR in older women. 13,14,33,34 This was also suggested by a meta-analysis that looked at the age-predicted HR in women and men. 31 The difference that we and others have noted in the age-predicted maximum HR in women is of great importance.…”

Section: Discussionmentioning

confidence: 78%

“…32 There is a small number of prior studies examining the association of age and peak HR achieved with exercise stress testing in women. 13,14,33,34 The studies included anywhere from 44 to 357 women. All of these studies in women suggest that the traditional age-predicted maximal HR overestimates the peak HR in younger women and underestimates the predicted peak HR in older women.…”

Section: Discussionmentioning

confidence: 99%

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Heart Rate Response to Exercise Stress Testing in Asymptomatic Women

et al. 2010

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Background-The definition of a normal heart rate (HR) response to exercise stress testing in women is poorly understood,given that most studies describing a normative response were predominately based on male data. Measures of an attenuated HR response (chronotropic incompetence) and age-predicted HR have not been validated in asymptomatic women. We investigated the association between HR response to exercise testing and age with prognosis in 5437 asymptomatic women. Methods and Results-Participants underwent a symptom-limited maximal stress test in 1992. HR reserve (change in HR from rest to peak), chronotropic index, and age-predicted peak HR were calculated. Deaths were identified to December 31, 2008. Mean age at baseline was 52Ϯ11 years, with 549 deaths (10%) over 15.9Ϯ2.2 years. Mean peak HR was inversely associated with age; mean peak HRϭ206 -0.88(age). After adjusting for exercise capacity and traditional cardiac risk factors, risk of death was reduced by 3% for every 1-beat-per-minute increase in peak HR, and by 2% for every 1-beat-per-minute increase in HR reserve (PϽ0.001). Inability to achieve 85% age-predicted HR was not an independent predictor of mortality, but being Ն1 SD below the mean predicted HR or a chronotropic index Ͻ0.80 based on the prediction model established by this cohort were independent predictors of mortality (PϽ0.001 and Pϭ0.023, respectively). Conclusions-Chronotropic incompetence is associated with an increased risk of death in asymptomatic women; however, the traditional male-based calculation overestimates the maximum HR for age in women. Sex-specific parameters of physiological HR response to exercise should be incorporated into clinical practice. Key Words: heart rate Ⅲ mortality Ⅲ exercise Ⅲ exercise test Ⅲ women T he definition of a normal response to exercise stress testing in women is poorly understood, given that most studies describing normative response were predominantly based on male data. [1][2][3][4] In particular, the normal heart rate (HR) response to exercise in women has not been well described. Previous studies in asymptomatic men and referral populations of both men and women have demonstrated that an attenuated HR response to exercise stress testing is an independent predictor of mortality and coronary disease. [5][6][7][8][9][10]

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Heart Rate Response to Exercise Stress Testing in Asymptomatic Women

et al. 2010

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“…PROFANT et al (1972) reported 0.8% decrement in VO2max per year of age. This figure agrees well with our Qmax mentioned above.…”

Section: Discussionmentioning

confidence: 96%

Maximum Cardiac Output Related to Sex and Age

Miyamura

Honda

1973

Jpn.J.Physiol

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Summary Maximum cardiac output (Qmax) was determined for 233 males (aged 9 through 53 years) and 102 females (aged 9 through 20 years) by the carbon dioxide rebreathing technique during bicycle exercise. Maximum cardiac output of the males progressively increased from 12.5 to 22.0 liter/min until age 17 through 18 years and was maintained at this level until age 24 years. From age 25 years a decrease in Qmax to 16.7 liter/min by age 53 years was observed. Qmax of the females increased from a level of 10.5 liter/min at age 9 years to a Qmaximum of 15.5 liter/min at age 18 years, maintaining this level through age 20 years. Male Qmax for comparable ages above 18 years was 30 % higher than female Qmax . Using the average Qmax value of males of 23-24 years as an optimum value, the decrement in Qmax with each year was approximately 0.9 %.The aerobic work capacity (maximum oxygen intake; 102.a.) of humans is known to decrease with increasing years from an optimum age (ROBINSON, 1939;ASTRAND, 1960;. Oxygen intake is strongly related to cardiac output and one of the limitations in oxygen intake must be in the circulatory ability to deliver oxygen to the working muscles. Unfortunately, data regarding the determination of cardiac output at VO2max have previously been reported for only a limited number of subjects representative of a narrow range in ages. Furthermore, data regarding the Qmax of females are limited. Therefore, this study was designed to systematically investigate the effect of increasing age, from 9 through 53 years, on Qmaximum cardiac output for males, and from 9 through 20 years for females. It was anticipated that such a study would define the role played by the cardiac output in the age-related decrease in maximum aerobic capacity and add to knowledge of the progressive increase in aerobic capacity of males and females during the developmental process of puberty.

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“…Sensitivity of the exercise test was defined as: Number of patients with (+ET) and significant coronary disease Number of patients with significant coronary disease X 100 (3) Specificity of the exercise test was defined as: Number of patients with (-ET) and no significant coronary disease x 100 Number of patients with no significant coronary disease (4) The prevalence of coronary atherosclerotic disease (P [D]) is given as:…”

Section: Analysis and Definitionsmentioning

confidence: 99%

Differences in electrocardiographic response to exercise of women and men: a non-Bayesian factor.

Barolsky¹,

Gilbert²,

Faruqui³

et al. 1979

Circulation

156

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SUMMARY We evaluated the ability of ST-segment analysis during submaximal exercise tolerance testing (85% predicted age-adjusted heart rate) to diagnose the presence of significant coronary artery stenosis (2 75% cross sectional area narrowing) in a group of 85 men and 92 women with chest pain syndromes and no previously documented myocardial infarctions. Disease prevalence by selective coronary angiography was 36% for men and 33% for women (NS). Predictive value of a positive exercise test (PV(+ET)) as defined by 1 mm ST-segment depression 0.08 second after the J point was significantly higher for men than for women (77% vs 47%, p < 0.05). Predictive value of a negative test (PV(-ET)) was not significantly different for men (81%) and women (78%). Analysis of the 66 men and 66 women not taking digitalis preparations again showed that PV(+ET) was significantly higher for men than for women (90% vs 45%, p < 0.01).Multivariate analysis showed that patients with angiographically significant coronary disease had significantly lower attained heart rates and shorter exercise duration than those without significant stenosis, independent of ST-segment responses. A discriminant function using ST-segment response, attained heart rate and a sex-dependent ST-segment response factor was developed. Duration of exercise was not an independent predictor by our analysis. This function improved the PV(+ET) and PV(-ET) for the total group and for the women; for men, the PV(-ET) improved, while the PV(+ET) fell slightly. This function has not yet been used prospectively.In patients with chest pain and no previously documented myocardial infarction, men have a significantly higher PV( + ET) than women, which cannot be accounted for simply by a difference in disease prevalence (i.e., Bayes' theorem).EXERCISE TESTING has been a commonly used tool for the evaluation of cardiac status for over 20 years. Despite its extensive use as a screening test for asymptomatic patients, a diagnostic test for patients with symptoms of ischemic heart disease, and as a functional test for patients with known cardiac disease, the usefulness, accuracy, and even basic methods for interpretation of the test remain controversial.Proper use of any test involves definition of the patient populations in which the diagnostic yield will be greatest. The use of exercise testing for diagnosis of coronary atherosclerotic heart disease in women with chest pain has also been controversial. Some authors '-5 Hospital from 1971-1977 were reviewed, and all patients evaluated for chest pain who had both coronary angiography and acceptable exercise tests within 6 months were identified. Patients with valvular heart disease, including mitral valve prolapse, congenital heart disease, idiopathic hypertrophic subaortic stenosis, left bundle branch block on the ECG, a history of chest surgery, or a previously documented myocardial infarction were excluded from the study. The diagnosis of a previous myocardial infarction was based on the finding of at least two of the followin...

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Responses to maximal exercise in healthy middle-aged women.

Cited by 77 publications

References 0 publications

Heart Rate Response to Exercise Stress Testing in Asymptomatic Women

Heart Rate Response to Exercise Stress Testing in Asymptomatic Women

Maximum Cardiac Output Related to Sex and Age

Differences in electrocardiographic response to exercise of women and men: a non-Bayesian factor.

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