Cleveland Clinic Research Shows ‘Estimated Age’ from Exercise Stress Test is Better Indicator than Actual Age of How Long You Live

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Cleveland Clinic researchers have developed a tool to calculate a person’s physiological age based on their exercise performance during a stress test and found this is a better predictor of how long they’ll live compared to their actual age.

Researchers studied 126,356 patients who were referred for an exercise treadmill testing at Cleveland Clinic between Jan. 1, 1991, and Feb. 27, 2015, to evaluate whether a patient’s estimated age based on their exercise performance is a better predictor of mortality when compared to chronological age.

The average age of study participants was 53.5 years old and 59 percent were male. The paper was published today in the European Journal of Preventive Cardiology.

The study found that the estimated age based on exercise performance was better in predicating survival than the patients’ actual age. This held true for both male and female cohorts, when considered separately. Among those included, 55% of males and 57% of females between the ages of 50 and 60 years had their estimated age younger than their chronologic age.

The formula to estimate physiological age was developed based on exercise variables that were collected at the time of the patient’s stress test.

The study further confirmed that all exercise variables included in estimating physiological age were powerful predictors of survival, including exercise capacity, chronotropic competence (heart rate response to exercise) and heart rate recovery.

“Physiological age based on your exercise performance on stress testing is an even better predictor on how long you will live,” said Serge Harb, M.D., a Cleveland Clinic cardiologist and first author of the study. “The key take-home message for patients is to exercise more, and for health care providers to use this physiological age as a way to motivate their patients to improve their exercise performance. For the first time we can quantify the impact of your performance level on a treadmill test in adding or subtracting years from your actual age.”

According to the CDC, heart disease is the leading cause of death among women and men in the United States. Stress testing is a common diagnostic tool for cardiovascular disease.

It is important to note that the study analyzed findings from a large population, and individual patients should always check with their healthcare provider before starting an exercise program.


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Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. Among Cleveland Clinic’s 72,500 employees worldwide are more than 5,050 salaried physicians and researchers, and 17,800 registered nurses and advanced practice providers, representing 140 medical specialties and subspecialties. Cleveland Clinic is a 6,500-bed health system that includes a 173-acre main campus near downtown Cleveland, 21 hospitals, more than 220 outpatient facilities, including locations in northeast Ohio; southeast Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2021, there were 10.2 million total outpatient visits, 304,000 hospital admissions and observations, and 259,000 surgical cases throughout Cleveland Clinic’s health system. Patients came for treatment from every state and 185 countries. Visit us at Follow us at News and resources available at

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