The maximal exercise ECG in asymptomatic men.

Lead MC5 bipolar exercise ECG was obtained in 510 asymptomatic males, aged 40 to 65, utilizing the bicycle ergometer, with maximal stress in 71% of the subjects. "Ischemic changes" occurred in 61 subjects, the frequency increasing from 4% at age 40 to 45, to 20% at age 50 to 55, to 37% at age 61 to 65. Subjects having an ischemic type ECG change on exercise had more frequent minor resting ECG changes, more resting hypertension, and a greater incidence of high cholesterol values than subjects with a normal ECG response to exercise, but there was no difference in the incidence of obesity, low fitness, or high systolic blood pressure after exercise. Current evidence suggests that asymptomatic male subjects with an abnormal exercise ECG develop clinical coronary heart disease from 2.5 to over 30 times more frequently than those with a normal exercise ECG.