Tuesday, August 19, 2014

Markers of fitness and all cause mortality

This study looked at outcomes of a population of patients with no known cardiovascular disease who underwent exercise testing. We wouldn't do such testing on health subjects nowadays but these data were gathered from 1993 to 2003:

Methods and Results We examined conventional cardiovascular risk factors and exercise test parameters in 6546 individuals (mean age 49 years, 58% men) with no known cardiovascular disease who were referred to our clinic for exercise stress testing between 1993 and 2003. The association of exercise parameters with mortality was assessed during a follow‐up of 8.1±3.7 years. A total of 285 patients died during the follow‐up period. Adjusting for age and sex, the variables associated with mortality were: smoking, diabetes, functional aerobic capacity (FAC), heart rate recovery (HRR), chronotropic incompetence, and angina during the exercise. Adjusting for cardiovascular risk factors (diabetes, smoking, body mass index, blood pressure, serum total, HDL, LDL cholesterol, and triglycerides) and other exercise variables in a multivariable model, the only exercise parameters independently associated with mortality were lower FAC (adjusted hazard ratio [HR] per 10% decrease in FAC, 1.21; 95% confidence interval [CI], 1.13 to 1.29; P less than 0.001), and abnormal HRR, defined as failure to decrease heart rate by 12 beats at 1 minute recovery (adjusted HR per 1‐beat decrease, 1.05; 95% CI, 1.03 to 1.07; P less than 0.001). The additive effects of FAC and HRR on mortality were also highly significant when considered as categorical variables.

Conclusion In this cohort of patients with no known cardiovascular disease who were referred for exercise electrocardiography, FAC and HRR were independently associated with all‐cause mortality.

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