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- Title
Cardiorespiratory fitness and risk of heart failure: a population-based follow-up study.
- Authors
Khan, Hassan; Kunutsor, Setor; Rauramaa, Rainer; Savonen, Kai; Kalogeropoulos, Andreas P.; Georgiopoulou, Vasiliki V.; Butler, Javed; Laukkanen, Jari A.
- Abstract
Aim To examine the relationship between cardiorespiratory fitness ( CRF) and risk of incident heart failure ( HF). Methods and results Cardiorespiratory 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). Conclusions In 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.
- Subjects
CARDIOPULMONARY system physiology; HEART failure risk factors; AEROBIC capacity; RESPIRATORY diseases; HEART beat; FOLLOW-up studies (Medicine); DATA analysis
- Publication
European Journal of Heart Failure, 2014, Vol 16, Issue 2, p180
- ISSN
1388-9842
- Publication type
Article
- DOI
10.1111/ejhf.37