This evaluation used to be a go-to for the pros—but should you perform it yourself?

By Lauren Wellbank
February 11, 2021
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Cardiovascular health is critical to your overall well-being, but you can't determine how healthy your heart truly is without in-office testing. And while scheduling a check-in with your doctor should never fall short on your priority list—COVID-19 pandemic or not—recently, many of us re-scheduled or pushed back our annual physicals, which is a time to voice any and all concerns (including those related to your heart!). If this scenario sounds familiar and you're experiencing anything unusual in your chest, call your doctor stat. But if you're in good health and simply want to know your heart's status, you might be curious about this in-home, self-administered exam: the stair test. But before you put on those running shoes and sprint up the nearest staircase, read up on what cardiologists have to say about doing this self-evaluation, which, they say, is often inaccurate.

Credit: Mike Kemp / Getty Images

What is the stair test?

The common stair test consists of quickly walking up three to four flights of stairs in 45 to 55 seconds, debriefs Dr. Stephen T. Sinatra, M.D., F.A.C.C., C.N.S., with Heart MD Institute and Vervana. In essence, the evaluation measures the amount of energy you expend when mounting several flights of stairs in such quick succession. For those who can accomplish it with little impact to their heart rate or without experiencing shortness of breath, it is estimated that they're using less energy to complete the test. Those who find themselves short of breath—or with a racing heart during or after—would be estimated to have used more energy, and are, therefore, not as healthy. "In my early training as a cardiologist, the stair test was still in vogue as a way to help diagnose the possibility of coronary artery disease," explains Dr. Sinatra. "Although the stair test is easy to perform, and did register some reliable data, the exercise treadmill became the standard for non-invasive screening for possible heart disease."

Who should attempt this at home?

If you're under the age of 40, less than 20 pounds overweight, and perform some sort of exercise like cycling, swimming, or walking the dog at least four to five times a week, Dr. Sinatra says you can attempt this test at home with minimal risk. "However, in people over the age of 40, who have undiagnosed hidden coronary artery disease, or have a common entity called silent ischemia in which patients are asymptomatic, but can have serious EKG changes on exercise, the stair test is not recommended and could be potentially dangerous," he says. "I am not in favor of doing this—under any circumstances—in those over the age of 40."

What should you do if you fail the test?

Dr. Sinatra says that anyone who performs a stair test and finds themselves experiencing breathlessness, fatigue, or discomfort anywhere in their body should seek medical attention. "Again, the stair test should only be performed by those who do regular exercise, who have no symptoms or shortness of breath, or chest discomfort, or are under the age of 40," he affirms. Otherwise, you run the risk of exacerbating undiagnosed or previously unrecognized conditions—which could have dire consequences.

When is it time to call your doctor?

If you're curious about your heart's health but don't meet Dr. Sinatra's qualifications to perform the test in your house, call your doctor to discuss testing that can be done under medical supervision. Your doctor can help address any questions and concerns—as well as walk you through any changes you need to make to achieve better heart health.

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