Gait Speed and Cardiovascular Disease by Glycemic Status
Kensuke Ueno1, Hidehiro Kaneko2, Kentaro Kamiya3
1Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan; Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan.
American Journal of Preventive Medicine
|February 9, 2023
Summary
Fast walking speed significantly lowers cardiovascular disease risk, especially in individuals with elevated HbA1c levels, indicating improved glucose tolerance maintenance is key for prevention.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Cardiovascular disease (CVD) is a leading cause of mortality globally.
- Glycemic status, indicated by HbA1c levels, is a known risk factor for CVD.
- The interplay between gait speed and CVD risk across different glycemic statuses requires further elucidation.
Purpose of the Study:
- To investigate whether the association between gait speed and incident cardiovascular disease is modified by baseline glycemic status.
- To determine if individuals with impaired glucose tolerance benefit more from faster gait speed in CVD prevention.
Main Methods:
- Retrospective observational cohort study using the Japan Medical Data Center Claims Database (2005-2021).
- Analysis of 3,090,048 participants without prior CVD history, categorized by HbA1c levels (<5.7%, 5.7-6.4%, ≥6.5%).
- Gait speed assessed via self-reported questionnaires; primary endpoint was a composite CVD outcome (heart failure, myocardial infarction, angina, stroke).
Main Results:
- A total of 116,678 composite CVD outcomes were documented during the follow-up period.
- Self-reported fast gait speed was associated with a reduced risk of developing CVD.
- This protective association was significantly stronger in participants with higher HbA1c levels (interaction p<0.001).
Conclusions:
- The relationship between gait speed and CVD risk is amplified in individuals with prediabetes or diabetes mellitus.
- Maintaining exercise capacity, reflected by gait speed, is particularly crucial for preventing CVD in those with impaired glucose tolerance.
- These findings highlight the importance of considering glycemic status when assessing CVD risk based on physical performance.
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