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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Estimated Cardiorespiratory Fitness and Incident Cardiometabolic Multimorbidity in Older Adults: A Prospective Cohort
Setor K Kunutsor1,2, Reyhaneh Rikhtehgaran1, Sae Young Jae3
1Section of Cardiology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada.
Objective:
To evaluate the association of estimated cardiorespiratory fitness (eCRF) with incident cardiometabolic multimorbidity (CMM) and its potential contribution to CMM risk prediction in an older adult population.
Patients And Methods:
The analysis included 3326 participants from the English Longitudinal Study of Aging (mean age 63 years; 1820 (54.7%) women) who were free of hypertension, cardiovascular disease, diabetes, and stroke at baseline (wave 4; 2008-2009). Estimated CRF was derived using validated nonexercise prediction equations (heart rate-based, body mass index-based, and Nord-Trøndelag Health Study-based eCRF). Incident CMM was defined at wave 10 (2021-2023) as the presence of ≥2 of the following: hypertension, cardiovascular disease, diabetes, or stroke. Multivariable-adjusted odds ratios (ORs) (95% CIs) and discrimination indices were calculated.
Results:
During 12-15 years of follow-up, 197 (5.9%) participants developed CMM. Each eCRF measure reported an inverse linear association with CMM risk. Higher heart rate-based eCRF was associated with lower odds of CMM (per 1- metabolic equivalents (MET) increment: OR=0.78; 95% CI, 0.70-0.87; highest vs lowest tertile: OR=0.42; 95% CI, 0.25-0.69). Similar associations were observed for body mass index-based eCRF (per 1-MET increment: OR=0.78; 95% CI, 0.68-0.89; highest vs lowest tertile: OR=0.42; 95% CI, 0.25-0.70) and Nord-Trøndelag Health Study-based eCRF (per 1-MET increment: OR=0.73; 95% CI, 0.65-0.82; highest vs lowest tertile: OR=0.36; 95% CI, 0.22-0.58). Incorporation of each eCRF measure into a conventional risk prediction model modestly improved discrimination.
Conclusion:
Estimated CRF derived from validated nonexercise equations was similarly and inversely associated with incident CMM in older adults, with all models reporting comparable modest predictive utility.
