Apart from the ECG, what else does the exercise ECG measure?
A positive exercise ECG usually means that that there was a problem visible on the strip of paper that records the heart's electrical activity. However, the exercise ECG measures much more than the heart's electrical activity. It also measures your fitness level, heart rate recovery, and blood pressure response. These factors can tell a lot about your risk for future heart problems.
What is heart rate recovery and how is it related to heart disease?
Your heart rate increases during exercise and returns to normal when you stop. Heart rate recovery measures how quickly your heart rate returns to normal after you stop exercising. An abnormal heart rate recovery means that your heart rate fails to decrease by 12 or more beats per minute within the first minute after you stop exercising. Studies show that women with an abnormal heart rate recovery have a higher risk for dying in the next 5 years.7 This is true for women who have—and those who have not—been diagnosed with heart disease.8, 9 In one small study men and women who participated in a 12-week cardiac rehabilitation program improved their heart rate recovery.10
How is blood pressure in response to exercise related to heart disease?
During exercise, your systolic blood pressure (top number) should rise while your diastolic blood pressure (bottom number) should stay the same. When you stop exercising after reaching your target heart rate, your systolic blood pressure (top number) should return to its pre-test level within 6 minutes. In some people, both blood pressure numbers increase excessively during exercise. This type of exaggerated response means you have an increased risk of being diagnosed with heart disease, having a heart attack, or developing high blood pressure in the future.11, 12 It does not appear to increase your risk of actually dying from heart disease.13
How is fitness related to heart disease risk?
How fit you are is a strong indicator of your risk of dying or having a heart attack. If you are unable to exercise long enough to reach the target heart rate for a women your age, you have a higher risk of dying than a woman who can.14 In men and women with heart disease, those able to exercise longer have a much lower risk of dying than less fit patients.15
How is fitness measured?
Fitness or exercise capacity is usually measured in metabolic equivalents (METs for short). Household tasks such as stripping and making the bed require about 5 METs. If you cannot perform 5 METs of exercise, you have a 3-fold higher risk of dying or having a heart attack than a woman capable of 8 METs of exercise. For every 1 MET increase in exercise capacity, the risk of dying falls by 17%.16 Healthy women, with a below-average fitness, are over 3 times more likely to die within 20 years than women with above average-exercise capacity.17 Because the relationship between fitness and the risk of dying is so strong, some researchers suggest that treadmill testing should be included in everyone's annual physical.
See also: Exercise and Your Heart Risk
