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Exercise test predicts CVD mortality risk
Performance on a simple exercise test predicts the risk
of death from cardiovascular disease, cancer, and other
causes, reports a large study presented at EuroEcho-Imaging
2018. Good performance on the test equates to climbing
three floors of stairs very fast, or four floors fast, without
stopping. The findings underline the importance of fitness
for longevity.
The study included 12 615 participants with known or
suspected coronary artery disease. Participants underwent
treadmill exercise echocardiography, in which they were
asked to walk or run, gradually increasing the intensity, and
continue until exhaustion. The test also generates images of
the heart to check its function.
During a median 4.7-year follow up, there were 1 253
cardiovascular deaths, 670 cancer deaths and 650 deaths
from other causes. After adjusting for age, gender and other
factors that could potentially influence the relationship, each
MET (metabolic equivalent) achieved was independently
associated with 9, 9 and 4% lower risks of cardiovascular
death, cancer death and other causes of death during follow
up.
The death rate from cardiovascular disease was nearly
three times higher in participants with poor compared
to good functional capacity (3.2 vs 1.2%,
p
<
0.001).
Non-cardiovascular and non-cancer deaths were also nearly
three-fold higher in those with poor compared to good
functional capacity (1.7 vs 0.6%,
p
<
0.001). Cancer deaths
were almost double in participants with poor compared to
good functional capacity (1.5 vs 0.8%,
p
<
0.001).
As expected, the imaging part of the examination was
predictive of cardiovascular death but not of deaths caused
by cancer or other conditions.
Study author Dr Jesús Peteiro, a cardiologist at the
University Hospital A Coruña, A Coruña, Spain, said: ‘Our
results provide further evidence of the benefits of exercise
and being fit on health and longevity. In addition to keeping
body weight down, physical activity has positive effects
on blood pressure and lipids, reduces inflammation, and
improves the body’s immune response to tumours.’
Peteiro said people do not need to undergo exercise
echocardiography to check their fitness level. ‘There are
much cheaper ways to estimate if you could achieve 10 METs
on the treadmill test,’ he said. ‘If you can walk very fast up
three floors of stairs without stopping, or fast up four floors
without stopping, you have good functional capacity. If not,
it’s a good indication that you need more exercise.’
ESC guidelines recommend at least 150 minutes a week
of moderate aerobic physical activity or 75 minutes a week
of vigorous aerobic physical activity, or a combination of the
two intensities.
Source:
Medical Brief 2019