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Cardiorespiratory Fitness Assessment Improves Accuracy of Health Predictions

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According to a new study in Proceedings of the Mayo Clinic, taking into account cardiorespiratory capacity (CRF) as well as traditional risk factors such as age, sex, blood pressure, cholesterol and smoking, improves the accuracy of the assessment of the risk of mortality.

“We found that in a contemporary adult UK population with a varied and relatively low pre-test risk profile, a higher CRF was strongly associated with a lower risk of mortality. The results provided insight into the incremental prognostic value. of a CRF assessment, “explained lead researcher Jari A. Laukkanen, MD, Ph.D., cardiologist, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland. “The predictive accuracy of CRF levels was even more evident when taken into account with traditional risk factors such as age, gender, blood pressure, cholesterol, and smoking.”

Although conventional risk factors such as age, gender, blood pressure, cholesterol, and smoking can contribute significantly to the risk of vascular disease and death, these established risk factors are often absent in many women. part of patients with cardiovascular disease. This contributes to the difficulties in identifying individuals at increased risk for vascular disease and / or death.

CRF is recognized as an important marker of both functional capacity and mortality, and there is ample literature showing that this measure is inversely and independently associated with vascular disease and mortality. However, physicians do not routinely assess fitness, either in general or specialized clinical settings, when looking for traditional risk factors.

This study was based on data from the large-scale UK Biobank study, which gathered information on nearly 60,000 participants between the ages of 40 and 69. He assessed CRF using a submaximal stress test in the form of a six-minute stationary bike protocol. This protocol is readily available, has a good safety, reliability and validity profile. Researchers assessed the impact of CRF assessment in relation to and in conjunction with risk factors typically measured in clinical practice. Investigators used mortality data from the National Health Service Information Center (England and Wales) and the Scottish Morbidity Record, from which they were able to rank the causes of death.

This is one of the first large-scale population-based studies showing that risk prediction can be improved in a preselected relatively low-risk population by adding information on the CRF, estimated based on a submaximal stress test, using conventional cardiovascular risk factors. During a median follow-up of 5.8 years, 936 deaths occurred in the study group.

“Do we really need to make CRF assessments a standard part of a medical exam? From what we have learned, the answer is “yes”. Our results clearly validate them as vital clinical risk predictors in conjunction with other factors, ”noted Dr Laukkanen. “Submaximal stress testing to account for CRF levels with conventional risk factors should be routinely used by clinicians to determine whether high-risk patients need additional interventions. “

In an accompaniment editorial, Carl J. Lavie, MD, cardiologist, John Ochsner Heart and Vascular Institute, Ochsner Clinical School — University of Queensland School of Medicine, New Orleans, LA, USA, and the co-authors observed that “Certainly, many studies show powerful impact Although the baseline assessment for CRF is the cardiopulmonary stress test and the use of gas exchange to measure peak oxygen uptake, many clinicians do not have easy access to such tests, and they also don’t have the equipment and staff to monitor them. tests, let alone the moderate expense of these tests. The unique aspect of the present UK Biobank study was to use a bike test submaximal of six minutes in a very large cohort to assess CRF and mortality combined with established CVD risk factors.

CRF is an index of usual physical activity, especially aerobic exercise. A good CRF helps prevent chronic disease, provides general well-being, and reduces the risk of premature death. In addition to good nutrition and adequate rest and relaxation, individuals can improve their physical condition by exercising regularly. Fitness and exercise are potential ways to avoid daily stress, which can have a huge impact on human health.

“We need to do a better job of promoting physical activity and physical training (aerobic and resistance) throughout the healthcare system, schools, the workplace and society for primary and secondary disease prevention. cardiovascular. The long-term health of our populations will depend on the success of these efforts, ”commented Dr. Lavie and his co-authors.

New research shows shorter fitness test still accurately predicts risk of death

More information:
“Prognostic relevance of the cardiorespiratory form evaluated by submaximal exercise tests for all-cause mortality: a prospective study by the British biobank”, Proceedings of the Mayo Clinic (2020). DOI: 10.1016 / j.mayocp.2019.12.030

Quote: Cardiorespiratory Fitness Assessment Improves Accuracy of Health Predictions (April 30, 2020) Retrieved January 8, 2022 from

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