Veteran athletes exercise at higher maximum heart rates than are achieved during standard exercise (stress) testing

Objective. The stress electrocardiogram (sECG) is routinely used to screen individuals for underlying cardiac pathology before an exercise programme i s prescribed. The underlying assumption is that the cardiac responses elici ted during the sECG test are similar to those achieved during participation in sporting activities. However, this premise may be incorrect since the p hysical demands of different modes of exercise vary substantially. Design. Ten veteran league squash players (LSP), 10 social squash players ( SSP), 10 league runners (LR), 10 social runners (SR) and 10 sedentary indiv iduals (SED) were recruited for the study. All subjects completed a lifesty le questionnaire, a full medical examination and a routine sECG. Thereafter each subject's heart rate (HR) was monitored on two separate occasions whi le participating in sporting activity. Results. No sECG exercise-induced abnormalities were observed, although fiv e subjects showed resting abnormalities. Maximal HR during the sECG, and ma ximal and mean HR during the Held tests, were not significantly different b etween groups. However, maximal HR was significantly higher in all groups d uring their sporting activities than during stress testing in the laborator y (P < 0.01). Conclusions. Maximal HR in veteran athletes during specific sporting activi ties was significantly higher than that attained during a routine sECG. Thi s finding was not sport-specific, nor was it related to the level of compet itiveness of the trial participants. These data show that a routine sECG is a submaximal test of exercise performance, and should be interpreted as su ch.