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Heart Attack Can Happen to the Healthy and the Young

It's a new use for an old test: doctors at the Cleveland Clinic say the exercise stress test can be a powerful predictor of risk of death among healthy people with no signs of heart disease. CBS correspondent Elizabeth Kaledin reports.

Traditionally, heart function is measured during a stress test. But doctors here took a look at how the heart recovered after the test: data never analyzed before.

They followed more than 5-thousand middle aged people for 12 years. About 10% of the people with a slow or abnormal heart rate recovery after exercise died compared to 4% with normal heart rate recovery.

"If the heart rate declines slowly after exercise the risk of death was about 2 1/2 times greater than in people in whom the heart rate fell quickly," says Dr. Michael Lauer at Cleveland Clinic.

"It is unknown if heart rate recovery after exercise can be improved," says Lauer. "So the results raise an interesting question. Is there any value in being able to identify a healthy population at higher risk of dying?"

Dr. Daniel Bloomfield at Columbia Presbyterian Medical Center says it is valuable and ethical to identify these patients because there is something they can do which is to get in shape, or quit smoking or lower cholesterol.

Dr. Daniel Bloomfield believes the new data will be the ultimate motivator. "Imagine the healthy 45-year-old man who gets negative results," says Bloomfield. "Now the patient says, I'm at higher risk, and he goes to the gym, gets started to lower his cholesterol and maybe that's enough to convert this guy from someone who's gonna have a heart attack five years later to someone who's not."

Doctors admit that they have few effective means of preventing heart disease. Perhaps the sobering ability to measure risk of death will be the most convincing preventive medicine yet.

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