Need for a Sex Specific Formula for Stress Testing
HealthDay News — The formula doctors use to evaluate treadmill stress tests, and thereby assess heart health, doesn’t account for important differences between men and women, based on preliminary findings presented at the American College of Cardiology annual meeting on March 30, 2014. Doctors now use the formula “220 minus age” to determine how hard patients should work out during exercise stress tests. Many people also use this formula to set their target heart rate during workouts.A revised formula would better determine peak exercise rate, or the maximum number of heart beats per minute, for each sex, the researchers said.
“Exercise physiology has been known to differ for men and women of different ages,” said Dr. Gregg Fonarow, associate chief of cardiology at the University of California, Los Angeles, and spokesman for the American Heart Association. The proposal for a sex-specific maximal heart rate warrants further research, he said. “This may represent a valuable improvement for guiding exercise stress testing,” added Fonarow, who was not involved in the study.
Dr. Thomas Allison, director of stress testing at the Mayo Clinic in Rochester, Minn., and his team reviewed 25,000 stress-test results that indicated significant differences between men and women. Although peak heart rate declines with age for both sexes, the rate declines more gradually in women. This difference results in an overestimated peak heart rate in younger women and underestimated peak heart rate in older women, the researchers said.
Based on their findings, the study authors proposed a new formula to determine a maximum heart rate:
- For women ages 40 to 89 should be 200 minus 67 percent of their age.
- For men, the preferred formula is 216 minus 93 percent of their age
“We want to make sure that when people do the stress test, they have an accurate expectation of what a normal peak heart rate is,” said Allison in an American College of Cardiology news release. Because of limited test results for women under 40, the researchers were unable to recommend a new formula for this group. The researchers also found that younger men have a lower resting heart rate and higher peak heart rate than women and men’s heart rates rise more dramatically during exercise and return to normal more quickly after stopping, the researchers said. However, the researchers cautioned that few women were represented among many of the medical studies.
“This is timely and we’ve needed it for a while,” said Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City.
“All of these differences are very important, not only for diagnosis, but also for teaching people how best to exercise to get the most cardiovascular fitness.”
However, Dr. Steinbaum suggests that more research is necessary before a new formula that takes sex differences into account can be adopted as the standard practice. Still, women might want to try the proposed formula for their own exercise routine.
“It’s logical that an equation developed 40 years ago based on a group that was predominantly men might not be accurate when applied to women today,” Dr. Allison said. Dr. Kevin Marzo, chief of cardiology at Winthrop-University Hospital in Mineola, N.Y., added that the original formula stems from research in the early 1970s.
“Once again we learn that men and women are very different and our medical research and treatments need to be gender- specific,” Dr. Marzo said.
