While the benefits of physical activity and exercise among older persons
are becoming increasingly clear, the role of exercise stress testing and safety
monitoring for older persons who want to start an exercise program is unclear.
Current guidelines regarding exercise stress testing likely are not applicable
to the majority of persons aged 75 years or older who are interested in restoring
or enhancing their physical function through a program of physical activity
and exercise. In addition to being expensive and of unproven benefit, the
current policy of routine exercise stress testing potentially could deter
many older persons from participating in an exercise program. Research is
needed to investigate current physician practices, evaluate the risk of adverse
cardiac events, determine the role of pharmacological stress testing, and
measure and compare absolute and relative exercise intensities. To assist
clinicians, we offer a set of recommendations regarding precautions that can
be taken to minimize the risk of adverse cardiac events among previously sedentary
older persons who do not have symptomatic cardiovascular disease and are interested
in starting an exercise program.
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The Rational Clinical Examination
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