Cardiorespiratory fitness and risk of heart failure: a population‐based follow‐up study

European Journal of Heart Failure - Tập 16 Số 2 - Trang 180-188 - 2014
Hassan Khan1, Setor K. Kunutsor1, Rainer Rauramaa2, Kai Savonen2, Andreas P. Kalogeropoulos3, Vasiliki V. Georgiopoulou3, Javed Butler3, Jari A. Laukkanen4,5
1Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
2Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
3Emory University, Atlanta, GA USA
4Department of Internal Medicine, Lapland Central Hospital, Rovaniemi, Finland
5Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland

Tóm tắt

AimTo examine the relationship between cardiorespiratory fitness (CRF) and risk of incident heart failure (HF).Methods and resultsCardiorespiratory fitness, as measured by maximal oxygen uptake (VO2max), was assessed at baseline in a prospective cohort of 1873 men aged 42–61 years without HF or chronic respiratory disease. During a mean follow‐up of 20.4 years, 152 incident HF events were recorded. Within‐person variability was calculated using data from repeat measurements taken 11 years apart. The age‐adjusted hazard ratio (HR) per unit increase (1 mL/kg/min of VO2max) in CRF was 0.89 [95% confidence interval (CI) 0.86–0.93], which was minimally attenuated to 0.94 (95% CI 0.90–0.98) after further adjustment for established HF risk factors (body mass index, systolic blood pressure, history of cardiovascular disease, diabetes, heart rate, and LV hypertrophy) and incident coronary events as a time‐varying covariate. In a comparison of extreme quartiles of CRF levels (VO2max ≥35.4 vs. ≤25.7 mL/kg/min), the corresponding HRs were 0.27 (0.15–0.50) and 0.48 (0.25–0.92), respectively. Each 1 MET (metabolic equivalent of oxygen consumption) increment in CRF was associated with a 21% (7–33%) reduction in multivariable adjusted risk of HF. Addition of CRF to a HF risk prediction model containing established risk factors did not significantly improve risk discrimination (C‐index change = 0.0164, P = 0.07).ConclusionsIn this Finnish population, there is a strong, inverse, and independent association between long‐term CRF and HF risk, consistent with a dose–response relationship. The protective effect of CRF on HF risk warrants further evaluation.

Từ khóa


Tài liệu tham khảo

10.1136/heart.83.5.596

10.1136/heartjnl-2012-302972

Bouchard C, 1994, Physical Activity, Fitness, and Health: International Proceedings and Consensus Statement, 569

10.1093/ptj/80.8.782

10.1001/archinte.161.6.825

10.1161/hc3901.095960

10.1001/jama.1996.03540030039029

10.1016/j.ehj.2004.06.013

10.1016/S0140-6736(98)02268-5

10.1056/NEJM198603063141003

10.1056/NEJM198811243192104

10.1001/jama.1989.03430170057028

10.1056/NEJM199302253280803

10.1001/jama.282.16.1547

10.1001/archinte.163.14.1682

10.1001/jama.2009.681

Salonen JT, 1988, Is there a continuing need for longitudinal epidemiologic research? The Kuopio Ischaemic Heart Disease Risk Factor Study, Ann Clin Res, 20, 46

10.1056/NEJM199406023302201

10.1111/j.1542-474X.2001.tb00129.x

10.1161/01.HYP.31.4.937

10.1038/sj.jhh.1001631

10.1016/j.jelectrocard.2012.08.051

10.1001/archinte.165.15.1788

10.1016/j.ijcard.2012.12.072

10.1093/eurjhf/hfs033

10.1161/CIRCHEARTFAILURE.108.768457

10.1093/oxfordjournals.aje.a010013

10.1002/sim.4780100703

10.1002/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO;2-4

10.1002/sim.4085

10.1002/sim.2929

10.1056/NEJM199604043341403

1996, Physical activity and cardiovascular health. NIH Consensus Development Panel on Physical Activity and Cardiovascular Health, JAMA, 276, 241, 10.1001/jama.1996.03540030075036

10.1056/NEJM200002173420702

10.1161/01.CIR.96.8.2534

10.1249/00005768-198315050-00009

10.1056/NEJMoa020194

10.1056/NEJM200105033441801

10.1001/jama.288.13.1622

10.1161/01.CIR.0000040584.91836.0D

10.1161/01.CIR.83.5.1692

10.1056/NEJMoa011858

10.1001/archinte.162.12.1333

10.1152/ajpheart.1998.274.2.H424

10.1097/00001648-200209000-00012

10.1161/01.ATV.0000036611.77940.F8

10.1016/j.ahj.2006.02.023

10.1161/01.CIR.0000057810.48709.F6

10.1016/j.jacc.2012.08.1006

Thông tin
Thông tin xuất bản

European Journal of Heart Failure

Tập 16 Số 2

180-188

Thông tin tác giả