Reasons for terminating an exercise test provide independent prognostic information: 2014 apparently healthy men followed for 26 years.
OBJECTIVE
We wanted to study whether reasons for terminating an exercise test might influence long-term mortality of healthy men, a previously unreported subject.


RESULTS
During 1972-75, 2014 men aged 40-59, free from somatic diseases and not using drugs, underwent an examination programme including case history, clinical examination, various blood tests, and a symptom limited exercise ECG-test. The following reasons for test termination were noted: impaired breathing, lower limb fatigue, exhaustion (=combined lower limb fatigue and impaired breathing), high heart rate, abnormal blood pressure response, heart arrhythmias, increasing chest pain during exercise, marked ST-depressions during the test, and refusal to continue. Follow-up was 26 years. When adjusting for age, men who stopped exercising exclusively because of impaired breathing (n=178) had a 1.86-fold increased risk (95% CI 1.34-2.60; P=0.0002) of dying from coronary heart disease (CHD), a 1.64-fold increased risk (95% CI 1.32-2.03; P<0.0001) of dying from any cause, and a 3.47-fold increased risk (95% CI 2.24-5.12; P<0.0001) of dying from pulmonary causes compared with men having defined exhaustion (n=1376). After adjustment for age, smoking, total serum cholesterol, fasting blood glucose, systolic blood pressure, and physical fitness, impaired breathing remained significantly associated to an increased risk of dying from CHD, pulmonary disease, or any causes.


CONCLUSIONS
Healthy men who stop bicycle exercising only because of impaired breathing have a high long-term CHD-, pulmonary-, and total-mortality, and such men may need further diagnostic scrutiny and follow-up.
Bodegard
Johan
J
Department of Clinical Epidemiology, University of Oslo, Akershus University Hospital, PO Box 75, NO-1474 Nordbyhagen, Norway. l.j.bodegard@klinmed.uio.no
Erikssen
Gunnar
G
Bjørnholt
Jørgen V
JV
Gjesdal
Knut
K
Liestøl
Knut
K
Erikssen
Jan
J
D000328:Adult; D000787:Angina Pectoris / Q000209:etiology / Q000401:mortality; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000401:mortality; D003327:Coronary Disease / Q000401:mortality*; D004562:Electrocardiography; D005080:Exercise Test / Q000009:adverse effects / Q000401:mortality*; D017079:Exercise Tolerance; D005221:Fatigue / Q000209:etiology / Q000401:mortality; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000401:mortality; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D010808:Physical Examination; D011379:Prognosis; D012120:Respiration Disorders / Q000209:etiology / Q000401:mortality*; D013997:Time Factors