Friday, February 03, 2006

You know your Framingham heart risk. Should you get a stress test?

The value of exercise testing (ET) in individuals without symptoms remains controversial. You might think you need an exercise stress test, yet your doctor doesn't, and vice versa.

The results from a new study indicate that ET improves the prediction of a first coronary event only in those individuals who are already at an elevated risk based on the Framingham risk assessment.

Positive exercise testing was associated with coronary event (CE) occurrence (including cardiac deaths, acute myocardial infarction and stable or unstable angina) only in subjects with higher test risk, defined by a 10-year Framingham score of greater than 10.4%.

In other words, if your test result was less than 10.4%, a stress test provided no more information on risk. If greater than 10.4%, then additional information was provided on your risk for a subsequent CE. As a matter of fact, subjects with a result between 10-15% and positive ET had a probability of CE largely equivalent to the probability in subjects with known coronary heart disease.

What is YOUR risk? Use the Framingham risk assessment tool to find out. (If you already have heart disease, stroke, peripheral arterial disease, abdominal aortic aneurysm, diabetes mellitus, or chronic kidney disease, you’re automatically considered to be at high risk.)

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