Introduction
Cardiovascular disease (CVD) is the principal cause of death in U.S. women. Peak oxygen
uptake is strongly related to mortality and CVD. This study aimed to investigate the
association between estimated peak oxygen uptake, determined using a moderate 1-km
walking test, and all-cause mortality in female patients with stable CVD.
Methods
Of the 482 women in our registry between 1997 and 2020, we included 430 participants
in the analysis (aged 67 [34–88] years). A Cox proportional hazard model was used
to determine the variables significantly associated with mortality. On the basis of
the peak oxygen uptake estimated using the 1-km walking test, the sample was subdivided
into tertiles, and mortality risk was calculated. The discriminatory accuracy of peak
oxygen uptake in estimating survival was assessed by receiver operating characteristic
curves. All results were adjusted for demographic and clinical covariates.
Results
A total of 135 deaths from any cause occurred over a median of 10.4 years (IQR=4.4–16.4),
with an average annual mortality of 4.2%. Estimated peak oxygen uptake was a stronger
predictor of all-cause mortality than demographic and clinical variables (c-statistic-0.767;
95% CI=0.72, 0.81; p<0.0001). The survival rate decreased from the highest tertile of fitness to the lowest.
Compared with the lowest group, hazard ratios (95% CIs) for the second and third tertiles
were 0.55 (0.37, 0.83) and 0.29 (0.16, 0.51), respectively (p for trend <0.0001).
Conclusions
Higher peak oxygen uptake levels were associated with a lower risk of all-cause mortality.
The indirect estimation of peak oxygen uptake using the 1-km walking test is feasible
and can be applied for risk stratification among female patients undergoing secondary
prevention programs.
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Article info
Publication history
Published online: March 02, 2023
Publication stage
In Press Journal Pre-ProofIdentification
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© 2023 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
