TY - JOUR
T1 - Risk factors for exercise-induced silent myocardial ischemia in healthy volunteers
AU - Katzel, Leslie I.
AU - Sorkin, John D.
AU - Colman, Eric
AU - Goldberg, Andrew P.
AU - Busby-Whitehead, M. Janette
AU - Lakatta, Loretta E.
AU - Becker, Lewis C.
AU - Lakatta, Edward G.
AU - Fleg, Jerome L.
N1 - Funding Information:
From the Department of Medicine, Division of Gerontology, University of Maryland School of Medicine and Geriatric Research Education and Clinical Center, Baltimore Veterans Affairs Medical Center, Labo ratory of Clinical Physiology (Metabolism Section) and Laboratory of Cardiovascular Science, Gerontology Research Center, National Institute on Aging (NIA), National Institutes of Health, Baltimore: and the Department of Medicine, Divisions of Geriatric Medicine and Gerontology, and Cardiology, Johns Hopkins University School of Medicine and the Francis Scott Key Medical Center, Baltimore. Maryland. This work was supported by NIA Clinical Investigator Award 5-K08-AGC0497, a Veterans Affairs Research Advisory grant, NIA intramural funds, NIA Clinical Investigator Award S-K08-AGOO383-02, the Johns Hopkins Academic Nursing Home Award POI AGO4402-05, General Clinical Research Center Grant MO1 RRO2719-03, the Veterans Affairs Geriatric Research Education and Clinical Center award, and National Institutes of Health Research Grant ROI-AGO7660 Manuscript received March 2X1994; revised manuscript received and accepted May 25, 1994.
PY - 1994/11/1
Y1 - 1994/11/1
N2 - This study determined the risk factors for exercise-induced silent ischemia (SI) in 281 apparently healthy volunteers aged 40 to 87 years and compared their risk factor profiles with those of 132 patients with overt coronary artery disease (CAD). SI (concordant exercise-induced asymptomatic ST-segment depression on electrocardiography and perfusion defects on tomographic thal-Hum-201 scintigraphy) was detected in 37 of 225 men (16%), versus 2 of 56 women (4%, p < 0.05). The prevalence of SI increased with age from 6% in men aged <55 years to 18% in men aged 55 to 70 years, and to 25% in men aged >70 years (p < 0.001). Compared with the 118 men with concordant normal exercise electrocardiogram and thallium scan (normals), men with SI were older (p < 0.001), and had a higher waist-to-hip ratio (p < 0.005), higher plasma triglyceride levels (p < 0.001), and lower high-density lipoprotein (HDL) cholesterol levels (p < 0.001). In stepwise logistic regression analysis, age, waist-to-hip ratio, and HDL levels were independent predictors of SI in men. Compared with 108 men with overt CAD, men with SI were younger (67 ± 2 vs 73 ± 1 years, p < 0.001) but had similar plasma lipids and waist-to-hip ratio. Thus, older age, male gender, abdominal obesity, and reduced HDL levels-all well-established risk factors for overt CAD-were risk factors for exercise-induced SI in these asymptomatic volunteers.
AB - This study determined the risk factors for exercise-induced silent ischemia (SI) in 281 apparently healthy volunteers aged 40 to 87 years and compared their risk factor profiles with those of 132 patients with overt coronary artery disease (CAD). SI (concordant exercise-induced asymptomatic ST-segment depression on electrocardiography and perfusion defects on tomographic thal-Hum-201 scintigraphy) was detected in 37 of 225 men (16%), versus 2 of 56 women (4%, p < 0.05). The prevalence of SI increased with age from 6% in men aged <55 years to 18% in men aged 55 to 70 years, and to 25% in men aged >70 years (p < 0.001). Compared with the 118 men with concordant normal exercise electrocardiogram and thallium scan (normals), men with SI were older (p < 0.001), and had a higher waist-to-hip ratio (p < 0.005), higher plasma triglyceride levels (p < 0.001), and lower high-density lipoprotein (HDL) cholesterol levels (p < 0.001). In stepwise logistic regression analysis, age, waist-to-hip ratio, and HDL levels were independent predictors of SI in men. Compared with 108 men with overt CAD, men with SI were younger (67 ± 2 vs 73 ± 1 years, p < 0.001) but had similar plasma lipids and waist-to-hip ratio. Thus, older age, male gender, abdominal obesity, and reduced HDL levels-all well-established risk factors for overt CAD-were risk factors for exercise-induced SI in these asymptomatic volunteers.
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U2 - 10.1016/0002-9149(94)90578-9
DO - 10.1016/0002-9149(94)90578-9
M3 - Article
C2 - 7977116
AN - SCOPUS:0028000284
VL - 74
SP - 869
EP - 874
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 9
ER -