Copyright © 1992 by the European Society of Cardiology.
© 1992 The European Society of Cardiology
The Tromsø study: the prevalence of exercise-induced silent myocardial ischaemia and relation to risk factors for coronary heart disease in an apparently healthy population
Institute of Community Medicine, University of Tromsø Norway
Received 13 May 1991; revised 27 September 1991; .
Correspondence Maja-Lisa Løchen, MD, University of Tromsø, Institute of Community Medicine, Breivika, N-9000 Tromsø, Norway.
Abstract
A random population sample of 294 men and 312 women aged 20–64 years, all apparently healthy, were examined following a screening to determine the prevalence of silent ischaemia and its relations to coronary risk factors. Based on exercise testing, the prevalence of silent ischaemia was 2.5% in men and 3.4% in women. In men, silent ischaemia was positively related to systolic blood pressure (P<0.001). The other risk factors did not show any significant associations with silent ischaemia. However, the men with silent ischaemia had a higher coronary heart disease risk score, and a tendency towards more symptoms and signs suggesting a poorer health status than the other men and the women. In the 21 men classified as ‘hypertensives’, silent ischaemia was more common than in the normotensive men (14% versus 2%, P<0.001). No such difference was observed in women. In conclusion, silent ischaemia may be a sign of hypertension and a generally increased risk of coronary heart disease in men, but probably not in the majority of women. This further supports that exercise electrocardiography has no role in screening asymptomatic persons for coronary heart disease, probably with the exception of middle-aged men with an increased risk.
Key Words: Coronary risk factors • exercise test • silent ischaemia • systolic blood pressure