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Impact of physiological aging beyond chronological aging on exercise time: lessons from a 25 year observational cohort

Session Poster session 1

Speaker Serge Harb

Event : ESC Congress 2016

  • Topic : preventive cardiology
  • Sub-topic : Exercise Testing
  • Session type : Poster Session

Authors : SCH Harb (Cleveland,US), LC Cho (Cleveland,US), YW Wu (Cleveland,US), CR Rouphael (Cleveland,US), PC Cremer (Cleveland,US), TG Guy (Cleveland,US), VM Menon (Cleveland,US), WAJ Jaber (Cleveland,US)

Authors:
S.C.H. Harb1 , L.C. Cho1 , Y.W. Wu1 , C.R. Rouphael1 , P.C. Cremer1 , T.G. Guy1 , V.M. Menon1 , W.A.J. Jaber1 , 1Cleveland Clinic Foundation, Cardiovascular Medicine - Cleveland - United States of America ,

Citation:
European Heart Journal ( 2016 ) 37 ( Abstract Supplement ), 129-130

Introduction: Treadmill exercise time is a reflection of exercise capacity and a major predictor of subsequent cardiovascular morbidity and mortality.

Purpose: Evaluate the change, by age category and time period, in exercise time in patients referred for exercise stress testing over a 25 year period.

Methods: All patients who underwent exercise stress testing: exercise ECG and exercise imaging (echo and nuclear) at our institution, from 1990 to 2014, were included. Patients' age, exercise testing date and exercise time in seconds (sec) were documented. Patients were divided into 4 groups based on their age: Group 1: <45 years; Group 2: 45–54 years; Group 3: 55–64 years and Group 4: >65 years. The 25 year study period was split into 5 time intervals: Interval #1: 1990–1994; Interval #2: 1995–1999; Interval #3: 2000–2004; Interval #4: 2005–2009 and Interval #5: 2010–2014. Median exercise time (median, 25–75 percentile) for each age group, at each interval, was measured. Trend permutation tests were used to detect significant changes in exercise times over the years. Two-sample Wilcoxon tests were used to compare exercise times among different groups.

Results: A total of 167,754 patients were included. Exercise times for the different age groups and time intervals are presented in table 1 (all exercise times are expressed in sec). For the same age group, there has been a significant decline (by trend permutation tests) in exercise time over the study period (figure 1). Two-sample Wilcoxon tests showed that the median exercise time [median (25–75 percentile) = 540 sec (430–600)] for age >65 in the 1990–1994 interval was statistically equivalent to that [540 sec (435–600)] for age 55–64 in the 1995–1999 interval, and to those (see table 1) for age 45–55 for the subsequent time intervals (2000–2014). Also, in every time interval, trend permutation tests showed a significant decrease in exercise time with increasing age group (figure 1).

Conclusion(s): As a proof of “physiological aging” beyond “chronological” aging, in a large population of patients referred for exercise stress testing over a 25 year period, there has been a significant decline in exercise time in all age groups (figure 1).

Exercise times in seconds
Time periodAge <45yrsAge 45–54 yrsAge 55–64 yrsAge >64 yrs
(N=39209)(N=47573)(N=44258)(N=36714)
1990–1994614 (530–270)*600 (540–660)553 (480–630)540 (430 (600)
1995–1999600 (520–701)560 (480–630)540 (435–600)480 (390–585)
2000–2004600 (495–690)540 (450–617)480 (394–597)425 (345–540)
2005–2009600 (495–720)540 (446–630)482 (388–588)410 (313–520)
2010–2014588 (480–688)540 (430–630)480 (369–579)406 (314–525)
*All exercise times are expressed as median (25–75 percentile); yrs = years.
Figure 1. Exercise times by age and time period

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