• Clinics · Jan 2019

    Non Electrocardiographic alterations in exercise testing in asymptomatic women. Associations with cardiovascular risk factors.

    • Ricardo Quental Coutinho, Ulisses Ramos Montarroyos, Isly Maria Lucena de Barros, Maria José Bezerra Guimarães, Laura Olinda Bregieiro Fernandes Costa, Ana Kelley de Lima Medeiros, Maria de Fátima Monteiro, Moacir de Novaes Lima Ferreira, William Azem Chalela, and Rodrigo Pedrosa.
    • Faculdade de Ciencias Medicas, Universidade de Pernambuco, Recife, PE, BR.
    • Clinics (Sao Paulo). 2019 Jan 1; 74: e1005.

    ObjectivesTo estimate the prevalence of exercise testing alterations in middle-aged women without symptoms of heart disease and to verify the associations of functional capacity and heart rate behavior during and after exercise with cardiovascular risk factors.MethodsA cross-sectional study was conducted with 509 asymptomatic women aged between 46 and 65 years who underwent clinical evaluations and exercise testing (Bruce protocol). The heart rate behavior was evaluated by the maximal predicted heart rate achieved, chronotropic index and recovery heart rate.ResultsThe mean age was 56.4±4.8 years, and 13.4% of the patients had a Framingham risk score above 10%. In the exercise treadmill testing, 58.0% presented one or more of the following alterations (listed in order of ascending prevalence): symptoms (angina, dyspnea, and dizziness), ST-segment depression, arrhythmia, reduction in recovery heart rate of ≤12 bpm at 1 minute, altered maximal predicted heart rate achieved, abnormal blood pressure, functional capacity deficiency, and altered chronotropic index. In the multivariate analysis, the following associations (odds ratio) were observed for these alterations: chronotropic index was associated with obesity (2.08) and smoking (4.47); maximal predicted heart rate achieved was associated with smoking (6.45); reduction in the recovery heart rate at 1 minute was associated with age (1.09) and obesity (2.78); functional capacity was associated with age (0.92), an overweight status (2.29) and obesity (6.51).ConclusionsMore than half of middle-aged women without cardiovascular symptoms present alterations in one or more exercise testing parameters. Alterations in the functional capacity or heart rate behavior, as verified by exercise testing, are associated with age, smoking, an overweight status and obesity.

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