U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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Monday, April 21, 2014

Division of Diabetes Treatment and Prevention - Leading the effort to treat and prevent diabetes in American Indians and Alaska Natives


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Exercise ECG Screening

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NOTE: Access to this information is not restricted; however, the information found here is intended for use by medical providers. Some videos contain graphic images. Patients should talk with their medical providers about any specific concerns.

Why is this important?

  • The risk of cardiovascular events increases as a direct function of:
    • Exercise intensity from Low to Moderate to Vigorous:
      • Low intensity exercise: <40% V02 max or aerobic capacity max
      • Moderate intensity exercise: 40-60% of VO2 max; 3-6 METs; intensity well within the individual’s capacity and can be comfortably sustained for a prolonged period of time (~45 minutes).
      • Vigorous intensity exercise: >60% of VO2 max; >6 METs; intense enough to represent a substantial cardiorespiratory challenge.
    • Presence of 2 or more risk factors that predict exercise-induced cardiovascular events.  down arrow up arrow
      • Age (male >45, female >55 yrs)
      • Family History (MI, Fam Hx CABG, SCD father <55 yrs or mother <65 yrs)
      • Cigarette smoking (current or previous 6 mos)
      • Sedentary lifestyle (no 30 minutes of moderate PA, 3x/wk for at least 3 mos)
      • Obesity (BMI >30)
      • Hypertension (>140/90)
      • Dyslipidemia (LDL >130, HDL <40)
      • Prediabetes (IFT or IGT)
  • American College of Sports Medicine (ACSM) has recommendations on when a medical examination and exercise ECG test is needed.

When to consider exercise ECG testing?

  • High-risk individuals engaged in moderate or vigorous exercise.
  • Moderate-risk individuals engaged in vigorous exercise.
  • Not needed for low-risk individuals involved in low to moderate levels of exercise.
    • Keep in mind this may be useful in establishing a safe and effective exercise prescription for these individuals.
  • Can help rule out electrocardiographic abnormalities and other associated CVD symptoms.
  • The ACSM testing recommendations and exercise related cardiovascular risk factors are summarized in the Decision Tree Figure [PDF - 43KB]
Overview How To Other Resources EHR Documentation

Division of Diabetes Treatment and Prevention | Phone: (505) 248-4182 | Fax: (505) 248-4188 | diabetesprogram@ihs.gov