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September 21, 1979, Vol 242, No. 12 >
ARTICLE | September 21, 1979

Exercise Testing-Reply

L. Howard Hartley, MD
JAMA. 1979;242(12):1259. doi:10.1001/jama.1979.03300120013011.
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In Reply.—  I certainly agree with the limitations imposed on the exercise test by the sensitivity and specificity of the exercise ECG, and I am on record as having so stated (N Engl J Med 293:400-401, 1975). However, a major objective of a larger scale exercise program would not be to identify coronary heart disease. In fact, even if coronary heart disease were identified, there is little that could be done to treat it with present technology. It is my opinion that the greatest use of exercise testing programs is for screening of persons who wish to begin an activity program.Of the men noted in the sample under study, 3% had high-grade ventricular ectopy. Also, an additional 2% to 3% had 2 mm or more of horizontal ST segment depression. An ST segment depression of that magnitude is extremely specific for myocardial ischemia. Accordingly, persons who have either high-grade

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