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August 28, 1981

Indications and Contraindications for Exercise Testing

Author Affiliations

From the Council on Scientific Affairs, American Medical Association, Chicago.

JAMA. 1981;246(9):1015-1018. doi:10.1001/jama.1981.03320090065037

EXERCISE testing has long provided a means to measure cardiovascular and physical fitness and was improved by the relatively recent addition of the ECG response to exertion. The Master's two-step test was accepted 35 years ago but today has been replaced by the treadmill or the bicycle ergometer, which uses a progression of mild to strenuous exercise. Safe protocols to be used for a progressive exercise test have been established,1,2 and the testing of cardiac fitness, both in normal and healthy subjects and patients, has become routine. Only recently, however, have data become available that allow comparison of coronary arteriography with the results of exercise testing in substantial numbers of asymptomatic subjects. This has shown a disturbingly high prevalence of both false-positive and false-negative test results, so that the value of such testing has recently been challenged.3 As a consequence, the Council on Scientific Affairs has requested several expert