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    Stress Test May Reveal a Man's Heart Risk

    Study Clarifies Value of Stress Testing in Men's Heart Health

    Determining Risk continued...

    Performing poorly on the exercise stress test strongly predicted a future heart event among men with the highest scores.

    Balady says high-risk men who fail to achieve a target heart rate on a treadmill test or perform poorly by other measures should receive the most aggressive preventive treatments available, including blood pressure and cholesterol-lowering medications. They may also be candidates for more specific diagnostic testing, such as imaging stress tests or angiography.

    The findings also suggest that regular exercise can lower heart disease risk no matter what a person's other risk factors are. Men who were able to exercise longer and more intensely had a lower risk of heart events, even among those men considered to be at high risk.

    "It does appear that being fitter lowers risk, even among high-risk individuals," Balady says.

    What About Women?

    Neither the Framingham nor the Cleveland Clinic study was able to measure the value of stress testing among women because the number of heart events among females in the studies was so low. Although as many women as men develop heart disease, they tend to do so later in life. Most of the women in the Framingham study were in their 40s and 50s.

    "We really can't say anything from these two studies, but earlier studies in women suggest that exercise testing is beneficial even among low-risk women," Balady says.

    American Heart Association spokesman Gerald Fletcher, MD, tells WebMD that the stress echo test, in which the treadmill test is combined with an echocardiogram, appears to be more accurate in women than a simple exercise treadmill test. Fletcher is a cardiologist in preventive medicine with the Mayo Clinic in Jacksonville, Fla.

    "The message is not that stress testing is not useful in women," he says. "We know that women have just as much heart disease as men, so it is important that we are just as aggressive in diagnosing the disease in women."

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