My wife and I are 77 and I am trying to exercise more. How do I know if I have heart disease? I have HBP which is under control with meds. My weight is 265 and I am 5′-8.” Does everyone who has HBP and over weight have heart disease?

Great question. Generally to assess heart disease, you will need a medical examination and possibly a clinical exercise test.

Healthy seniors are recommended to get a test for heart disease if they plan on vigorous exercise only. If you plan on moderate exercise, it is usually OK.

If you have any cardiac risk factors you definitely want to get a exam and possibly a clinical exercise test. Signs of heart disease include, pain or discomfort in the chest, neck, and jaw; shortness of breath at rest or with mild exertion; dizziness or fainting; trouble breathing at night or missing breaths; ankle swelling; palpitations in your chest; pain in your legs with exercise; heart murmur; unusual fatigue or shortness of breath with usual activities.

The clinical exercise test is usually what we call a maximal test in which you walk then run on a treadmill, while a doctor and other trained personal are continually monitoring your progress.

If you cannot tolerate this type of test, you may be given a sub-maximal test which can also provide useful information. This can include just walking fast on a treadmill, using an “arm bike” or regular leg bike for testing.

Easier tests do not provide good information on your heart but can shed light on your functional capacity and how you respond to exercise.