Longitudinal Algorithms to Estimate Cardiorespiratory Fitness Associations With Nonfatal Cardiovascular Disease and Disease-Specific Mortality
Longitudinal Algorithms to Estimate Cardiorespiratory Fitness Associations With Nonfatal Cardiovascular Disease and Disease-Specific Mortality
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DOI：
10.1016/j.jacc.2014.03.008
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发表时间：
2014-06-03
影响因子：
24
通讯作者：
Blair, Steven N.
中科院分区：
文献类型：
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作者：
Artero, Enrique G.;Jackson, Andrew S.;Blair, Steven N.
目的本研究旨在确定心肺适能（CRF）算法在不进行运动试验的情况下预测非致命性心血管疾病（CVD）事件和疾病特异性死亡率的风险的能力。来自有氧运动中心纵向研究的356名成年人（21%为女性），在1974年至2003年期间进行了随访。根据性别、年龄、体重指数、腰围、静息心率、体力活动水平和吸烟状况确定估计的CRF。通过最大跑台试验测量实际CRF。每1代谢当量增加的风险降低，辨别能力（c统计），和净重新分类的改善determined.Results在中位随访14.5年，1,934例死亡，627由于心血管疾病。在18,095名参与者的子样本中，确定了1,049例非致命性CVD事件。校正潜在混杂因素后，CRF测量值和估计值均与男性全因死亡率、CVD相关死亡率和非致死性CVD事件以及女性全因死亡率和非致死性CVD事件的风险呈负相关。每增加1代谢当量的风险降低范围约为10%至20%。测量的CRF具有稍好的区分能力（c统计）比估计的CRF，和净重新分类改善值在测量的CRF与估计的CRF是12.3%，男性（p < 0.05），女性为19.8%结论这些CRF算法利用常规收集的信息来获得CRF的估计值，其提供健康状态的有效指示。除了识别处于风险中的人之外，这种方法还可以提供反映初始CRF水平的更适当的锻炼建议。(C)2014年美国心脏病学会基金会
Objectives This study sought to determine the capacity of cardiorespiratory fitness (CRF) algorithms without exercise testing to predict the risk for nonfatal cardiovascular disease (CVD) events and disease-specific mortality.Background Cardiorespiratory fitness (CRF) is not routinely measured, as it requires trained personnel and specialized equipment.Methods Participants were 43,356 adults (21% women) from the Aerobics Center Longitudinal Study, followed up between 1974 and 2003. Estimated CRF was determined on the basis of sex, age, body mass index, waist circumference, resting heart rate, physical activity level, and smoking status. Actual CRF was measured by a maximal treadmill test. Risk reduction per 1-metabolic equivalent increase, discriminative ability (c statistic), and net reclassification improvement were determined.Results During a median follow-up of 14.5 years, 1,934 deaths occurred, 627 due to CVD. In a subsample of 18,095 participants, 1,049 cases of nonfatal CVD events were ascertained. After adjustment for potential confounders, both measured and estimated CRF were inversely associated with risks for all-cause mortality, CVD-related mortality and nonfatal CVD events in men, and all-cause mortality and nonfatal CVD events in women. The risk reduction per 1-metabolic equivalent increase ranged from approximately 10% to 20%. Measured CRF had a slightly better discriminative ability (c statistic) than did estimated CRF, and the net reclassification improvement values in measured CRF versus estimated CRF were 12.3% in men (p < 0.05) and 19.8% in women (p < 0.001).Conclusions These CRF algorithms utilized information routinely collected to obtain an estimate of CRF, which provides a valid indication of health status. In addition to identifying people at risk, this method can provide more appropriate exercise recommendations that reflect initial CRF levels. (C) 2014 by the American College of Cardiology Foundation