Whitman M, et al. - As markers of cardiac workload during exercise stress echocardiograms (ESE), maximal heart rate blood pressure product (MHRBPP) and age-predicted maximum heart rate (APMHR) were evaluated in this study using cardiovascular (CV) events at mean follow-up as the outcome variable. Using the standard Bruce protocol, an ESE to volitional fatigue was performed with 712 patients being examined for ischemic heart disease. Using demographics and test data, patients were observed for 4.4 ± 2.1 years. Significantly more CV events occurred in those achieving an APMHR >85% but MHRBPP <25060 vs achieving an MHRBPP >25060 irrespective of APMHR. Overall, in patients performing an otherwise negative ESE for myocardial ischemia detection, future CV events were better predicted by MHRBPP than APMHR alone.