Diagnostic and prognostic information derived from exercise testing.
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Adult↗
Biomedical subjects
W H Allen
Publications and source records attributed to W H Allen.
Treadmill exercise testing of mass screening for coronary risk factors.
The prevalence of an abnormal maximal treadmill stress test (MTST) was correlated with coronary risk factors in 1,077 asymptomatic adults (709 men and 368 women) in Long Beach, California. Of 1,077 adults, 113 (10.5%) had a positive MTST. A positive MTST was correlated with sex (p less than 0.001), age (p less than 0.001), a serum cholesterol less than or equal to 200 mg% (p less than 0.02), hypertriglyceridemia (p less than 0.05), cigarette smoking (p less than 0.025), and with the number of coronary risk factors (p less than 0.005) but not with hypertension, cigar or pipe smoking, obesity, or blood sugar.
Adult↗
Mass screening for coronary risk factors in 2,524 asymptomatic adults.
The prevalence of coronary risk factors was assessed in 2,524 asymptomatic adults in Long Beach, California. Hypercholesterolemia (serum cholesterol level greater than 250 mg/100 ml) was present in 725 subjects (28.8 per cent), hypertriglyceridemia (serum triglyceride level greater than or equal to 150 mg/100 ml) in 497 (19.7 per cent), and an abnormal lipoprotein pattern in 813 (32.2 per cent). Of the 2,524 subjects, 233 (9.2 per cent) had a blood pressure above 140/90 mm Hg and 116 (4.6 percent) had a blood pressure above 150/100 mm. There were 1,043 cigarette, cigar, or pipe smokers (41.3 per cent). Fifty subjects (2.0 per cent) had a fasting blood sugar level above 120 mg/100 ml, 48 (1.9 per cent) had abnormal triceps skinfold thickness, and 382 (15.2 per cent) weighed 20 per cent or more above the desirable weight. The electrocardiogram during rest was definitely above the desirable weight. The electrocardiogram during rest was definitely abnormal in 183 subjects (7.3 per cent). On the basis of these data it is evident that in many asymptomatic adults, risk factors predisposing to coronary disease are not being detected or treated.
Adolescent↗
Follow-up of mass screening for coronary risk factors in 1817 adults.
The prevalence of coronary risk factors was assessed in 1,817 asymptomatic adults in Long Beach, California, at the beginning and end of a 10-11 month interval. The risk factors evaluated were hypercholesterolemia, hypertriglyceridemia, hypertension, smoking, hyperglycemia, and marked obesity. The results of the tests were sent to the participants and to their physicians. An educational program aimed at reducing coronary risk factors was offered to the first 1,250 persons screened. Eight hundred and seventy-two of those 1,250 allocated to the education group returned for a second screening. The prevalence of 0, 1, 2, 3, 4, 5, or 6 coronary risk factors did not change significantly between the two screens in either the total group of 1,817 adults or in the 872 adults in the educational program. The Long Beach Heart Association mass screening program for coronary risk factors was ineffective in reducing the number of coronary risk factors.
Adult↗
Response of patients and physicians to mass screening for coronary risk factors.
Qestionnaires were sent to 1,817 adults screened twice for coronary risk factors 10 to 11 months apart and to their physicians. Physician questionnaires returned on 1,764 persons indicated that 359 (20.4%) of the total group and 227 of 1,191 persons (19.1%) with one or more abnormal risk factors during the first screen did not return for follow-up care. Only persons with one or more risk factors were given advice or medication. When the 227 patients that did not return for follow-up are removed from the group with one or more risk factors, the 239 patients who received advice or treatment comprise 24.8% of those who could have been treated. Of the total 1,764 patients, 13.5% recieved treatment or advice. Qestionnaires returned by 1,396 persons who received follow-up care by their physicians confirmed that only those who had one or more risk factors received advice or treatment. Results of the patient questionnaires show that 223 persons received advice or treatment (23.2% of all with risk factors who returned for follow-up; 16.0% of the 1,396 persons). Furthermore, of 116 persons prescribed medication for risk factor control, 60 (51.7%) were not taking this medication. Of 20, persons given advice for reduction of risk factors, 162 (78.9%) were not following this advice. These data indicate physician indifference and patient apathy to reduction of coronary risk factors in asymptomatic individuals.
Attitude to Health↗