Background-The prognostic value of treadmill exercise testing (TMET) has be
en studied in selected populations. The generalizability of these data to d
ifferent populations and to women is uncertain.
Methods and Results-A retrospective, population-based cohort study of all p
ersons (1452 men and 741 women) who underwent TMET in years 1987 to 1989 in
Olmsted County, Minnesota, was undertaken. Individuals were followed up fo
r all-cause mortality and cardiac events (cardiac deaths, nonfatal myocardi
al infarction, or congestive heart failure). Sex-specific analyses were per
formed to determine whether the predictors of outcome and the magnitude of
the associations were similar in both sexes. In men, 77 deaths and 106 card
iac events occurred during 8956 person-years of observation; in women, 46 d
eaths and 54 cardiac events occurred during 4801 person-years of follow-up.
Exercise-induced angina, ECG changes, and workload achieved on the TMET we
re strongly associated with all-cause mortality and cardiac events in both
sexes, and the strength of the association was similar. After adjustment, w
orkload was the only TMET variable associated with outcome. A higher worklo
ad was associated with a reduction in the risk of cardiac events and of all
-cause mortality; the protective effect of exercise capacity was strong and
was similar in both sexes.
Conclusions-In this population-based cohort, exercise capacity was the TMET
variable that exhibited the strongest association with all-cause mortality
and cardiac events. This protective effect of exercise capacity was observ
ed in both sexes.