Key result
Exercise blood pressure and fitness predict cardiovascular disease, which developed in ~53% of healthy men.
Why the study?
The study was designed to investigate the prevalence and predictors of silent coronary disease in Norwegian middle-aged men, specifically validating exercise ECG findings compared with angiography.
What are the prevalence of silent coronary heart disease and the long-term clinical, exercise ECG, and physiological predictors of cardiovascular morbidity, cancer, and mortality in initially healthy middle-aged Norwegian men?
Cohort (n=2,014)
No
What are the prevalence of silent coronary heart disease and the long-term clinical, exercise ECG, and physiological predictors of cardiovascular morbidity, cancer, and mortality in initially healthy middle-aged Norwegian men?
This 45-year cohort profile of the Oslo Ischaemia Study demonstrates that asymptomatic positive exercise ECG findings, exercise blood pressure responses, and physical fitness changes are potent long-term predictors of cardiovascular morbidity and mortality in initially healthy middle-aged men.
Exercise BP and fitness may aid long-term risk stratification in middle-aged men; leaves open whether modifying them alters CVD or mortality outcomes.
PURPOSE: The Oslo Ischaemia Study was designed to investigate the prevalence and predictors of silent coronary disease in Norwegian middle-aged men, specifically validating exercise electrocardiography (ECG) findings compared with angiography. The study has been important in investigating long-term predictors of cardiovascular morbidity and mortality, as well as investigating a broad spectrum of epidemiological and public health perspectives. PARTICIPANTS: In 1972-1975, 2014 healthy men, 40-59 years old, were enrolled in the study. Comprehensive clinical examination included an ECG-monitored exercise test at baseline and follow-ups. The cohort has been re-examined four times during 20 years. Linkage to health records and national health registries has ensured complete endpoint registration of morbidity until the end of 2006, and cancer and mortality until the end of 2017. FINDINGS TO DATE: The early study results provided new evidence, as many participants with a positive exercise ECG, but no chest pain ('silent ischaemia'), did not have significant coronary artery stenosis after all. Still, they were over-represented with coronary disease after years of follow-up. Furthermore, participants with the highest physical fitness had lower risk of cardiovascular disease, and the magnitude of blood pressure responses to moderate exercise was shown to influence the risk of cardiovascular disease and mortality. With time, follow-up data allowed the scope of research to expand into other fields of medicine, with the aim of investigating predictors and the importance of lifestyle and risk factors. FUTURE PLANS: Recently, the Oslo Ischaemia Study has been found worthy, as the first scientific study, to be preserved by The National Archives of Norway. All the study material will be digitised, free to use and accessible for all. In 2030, the Oslo Ischaemia Study will be linked to the Norwegian Cause of Death Registry to obtain complete follow-up to death. Thus, a broad spectrum of additional opportunities opens.
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Falk et al. (2021) conducted a cohort in Silent coronary heart disease and long-term cardiovascular risk in healthy men (n=2,014). Comprehensive clinical examination including bicycle exercise ECG testing, physical fitness, and blood pressure response assessment was evaluated on Long-term incidence of cardiovascular disease, cancer, and all-cause mortality.
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