Approved research

Exercise testing and electrocardiogram in the prediction of cardiovascular diseases

Lay summary

Exercise capacity has been suggested to be one of the strongest predictors for death from cardiovascular diseases (CVDs). However, it is not well known to which extent the incremental prognostic information offered by the assessment of exercise capacity (maximal workload) in risk stratification beyond that of conventional risk factors that would prompt interventions and ultimately reduce CVD-related events. The clinical importance of exercise and resting electrocardiogram (ECG) is still unclear in large general population, and thus this question should be further clarified. An unanswered question is if new population-based information can be used to implement a stronger recommendation in favor of routine exercise capacity (i.e. maximal workload) and/or resting and exercise ECG recordings for risk assessment in addition to traditional risk factors. If these exercise test measures (workload, ECG or heart rate) were to be used as additional screening tools in general population, clinicians would need to identify thresholds that could be used for the targeting of prevention. This large population study would be ideal to test further these clinically important questions. We will perform analyses to determine the levels of exercise capacity and ECG abnormalities in this study population. Secondly, we aim to study baseline associations between exercise capacity, ECG abnormalities and traditional risk factors and physiological variables (indicating cardiac and pulmonary function). We will investigate the associations between exercise capacity, heart rate and ECG abnormalities with the risk of cardiovascular events; quantify if associations differ by various subgroups including participants with or without common risk factors. The full cohort data with the assessment of exercise testing (maximal workload, heart rate) and electrocardiograms (ECGs). The assessment of exercise ECG is covering 95,071 participants.