Exercise stress testing is useful, safe, and efficient even in patients aged 75 years or older

To describe the clinical and hemodynamic variables obtained with exercise testing in elderly patients SW >75 years.

This study assessed 100 patients aged 75-94 years (80+/-4 years) undergoing symptom-limited exercise testing, 65% of whom were asymptomatic, 25% had nonanginal chest pain, and 10% had typical precordialgia. Of the 100 patients, 32% were males, 50% were hypertensive, 36% were dyslipidemic, 14% were diabetic, and 9% had had previous coronary artery disease. A ramp-adaptation of the Bruce protocol (ramped Bruce protocol) was used, preceded by a 1-minute warm-up with no treadmill incline and a velocity of 1.0 mph.

No complications were observed, and 92% of the tests were efficient. On average, the patients reached 95% of the maximum heart rate predicted. The mean duration of the test and the mean metabolic equivalent reached were, respectively, 6.8 +/-2 minutes and 6.6 +/-2.3 METs. Eleven patients had a hyperreactive inotropic response, and 37% of the sample had noncomplex ventricular and supraventricular arrhythmias. Eighteen percent of the tests were positive for myocardial ischemia. The patients with typical precordialgia had more ischemic responses than did those with nonanginal chest pain or those who were asymptomatic: 70% vs 16% (P<0.001) and 70% vs 10% (P<0.01), respectively.

The symptom-limited exercise test is useful, safe, and efficient for analyzing ischemic and hemodynamic responses, even in very elderly individuals.