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Role of cardiorespiratory fitness in lifetime cardiovascular risk prediction models: a cross-sectional analysis

Benjamin J Gray, Jeffrey W Stephens, Michael Thomas, Sally P Williams, Christine A Davies, Richard Bracken Orcid Logo

The Lancet, Volume: 390, Start page: S40

Swansea University Author: Richard Bracken Orcid Logo

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DOI (Published version): 10.1016/S0140-6736(17)32975-6

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BackgroundDespite well-established associations between cardiorespiratory fitness (CRF) and long-term cardiovascular disease risk, CRF remains underused in clinical practice. With a growing emphasis on longer-term risk, developments to UK cardiovascular disease risk equations such as the Joint Briti...

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Published in: The Lancet
ISSN: 0140-6736
Published: 2017
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URI: https://cronfa.swan.ac.uk/Record/cronfa37110
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2017-11-28T12:52:41.8196199</datestamp><bib-version>v2</bib-version><id>37110</id><entry>2017-11-28</entry><title>Role of cardiorespiratory fitness in lifetime cardiovascular risk prediction models: a cross-sectional analysis</title><swanseaauthors><author><sid>f5da81cd18adfdedb2ccb845bddc12f7</sid><ORCID>0000-0002-6986-6449</ORCID><firstname>Richard</firstname><surname>Bracken</surname><name>Richard Bracken</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2017-11-28</date><deptcode>STSC</deptcode><abstract>BackgroundDespite well-established associations between cardiorespiratory fitness (CRF) and long-term cardiovascular disease risk, CRF remains underused in clinical practice. With a growing emphasis on longer-term risk, developments to UK cardiovascular disease risk equations such as the Joint British Societies' 3 (JBS3) calculator now see the prediction of both lifetime and short-term risk. However, unlike the US LifetimeRisk model, the JBS3 algorithm does not include CRF as a risk variable. The aim of this study was to examine whether differences in CRF values are reflected in long-term cardiovascular disease risk prediction scores using a risk equation that includes CRF in the design (LifetimeRisk) and one that does not (JBS3).MethodsA retrospective, cross-sectional analysis was performed on 81 male steelworkers who participated in the second phase of the Prosiect Sir G&#xE2;r workplace-based cardiovascular disease risk assessment initiative in Carmarthenshire, Wales. CRF was calculated with a validated and reliable submaximal protocol based on heart rate responses (Chester Step Test). Between-group CRF differences (excellent or good vs average or below average) were determined by independent sample t test or Mann-Whitney U test, and any association between CRF and individual risk scores investigated by Pearson's correlation.FindingsMen in the lower CRF categories had greater body-mass index scores than men in the higher CRF categories (p=0&#xB7;001); and less desirable blood lipid profiles with higher total cholesterol (p=0&#xB7;041) and non-HDL cholesterol (p=0&#xB7;019) concentrations. The predicted long-term cardiovascular disease risk in the LifetimeRisk model was also greater in the lower fitness group than higher fitness group (mean 13&#xB7;6% [SD 2&#xB7;9] vs 7&#xB7;2 [1&#xB7;9], p&lt;0&#xB7;0001), and a negative correlation was evident between individual CRF values and predicted risk scores (r=&#x2013;0&#xB7;603, p&lt;0&#xB7;0001). However, there were no differences between CRF groups in predicted JBS3 lifetime risk (median 79 years [IQR 77&#x2013;80] vs 79 [78&#x2013;80], p=0&#xB7;354).InterpretationThese preliminary observations demonstrate that the LifetimeRisk prediction scores more accurately represent the current literature between CRF and longer-term cardiovascular disease risk in a group of white men. Although, more research is required, this study raises an important question as to whether CRF should be considered in the design of future UK long-term cardiovascular disease risk equations.</abstract><type>Journal Article</type><journal>The Lancet</journal><volume>390</volume><paginationStart>S40</paginationStart><publisher/><issnPrint>0140-6736</issnPrint><keywords/><publishedDay>30</publishedDay><publishedMonth>11</publishedMonth><publishedYear>2017</publishedYear><publishedDate>2017-11-30</publishedDate><doi>10.1016/S0140-6736(17)32975-6</doi><url/><notes/><college>COLLEGE NANME</college><department>Sport and Exercise Sciences</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>STSC</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2017-11-28T12:52:41.8196199</lastEdited><Created>2017-11-28T12:49:34.0355422</Created><path><level id="1">Faculty of Science and Engineering</level><level id="2">School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences</level></path><authors><author><firstname>Benjamin J</firstname><surname>Gray</surname><order>1</order></author><author><firstname>Jeffrey W</firstname><surname>Stephens</surname><order>2</order></author><author><firstname>Michael</firstname><surname>Thomas</surname><order>3</order></author><author><firstname>Sally P</firstname><surname>Williams</surname><order>4</order></author><author><firstname>Christine A</firstname><surname>Davies</surname><order>5</order></author><author><firstname>Richard</firstname><surname>Bracken</surname><orcid>0000-0002-6986-6449</orcid><order>6</order></author></authors><documents/><OutputDurs/></rfc1807>
spelling 2017-11-28T12:52:41.8196199 v2 37110 2017-11-28 Role of cardiorespiratory fitness in lifetime cardiovascular risk prediction models: a cross-sectional analysis f5da81cd18adfdedb2ccb845bddc12f7 0000-0002-6986-6449 Richard Bracken Richard Bracken true false 2017-11-28 STSC BackgroundDespite well-established associations between cardiorespiratory fitness (CRF) and long-term cardiovascular disease risk, CRF remains underused in clinical practice. With a growing emphasis on longer-term risk, developments to UK cardiovascular disease risk equations such as the Joint British Societies' 3 (JBS3) calculator now see the prediction of both lifetime and short-term risk. However, unlike the US LifetimeRisk model, the JBS3 algorithm does not include CRF as a risk variable. The aim of this study was to examine whether differences in CRF values are reflected in long-term cardiovascular disease risk prediction scores using a risk equation that includes CRF in the design (LifetimeRisk) and one that does not (JBS3).MethodsA retrospective, cross-sectional analysis was performed on 81 male steelworkers who participated in the second phase of the Prosiect Sir Gâr workplace-based cardiovascular disease risk assessment initiative in Carmarthenshire, Wales. CRF was calculated with a validated and reliable submaximal protocol based on heart rate responses (Chester Step Test). Between-group CRF differences (excellent or good vs average or below average) were determined by independent sample t test or Mann-Whitney U test, and any association between CRF and individual risk scores investigated by Pearson's correlation.FindingsMen in the lower CRF categories had greater body-mass index scores than men in the higher CRF categories (p=0·001); and less desirable blood lipid profiles with higher total cholesterol (p=0·041) and non-HDL cholesterol (p=0·019) concentrations. The predicted long-term cardiovascular disease risk in the LifetimeRisk model was also greater in the lower fitness group than higher fitness group (mean 13·6% [SD 2·9] vs 7·2 [1·9], p<0·0001), and a negative correlation was evident between individual CRF values and predicted risk scores (r=–0·603, p<0·0001). However, there were no differences between CRF groups in predicted JBS3 lifetime risk (median 79 years [IQR 77–80] vs 79 [78–80], p=0·354).InterpretationThese preliminary observations demonstrate that the LifetimeRisk prediction scores more accurately represent the current literature between CRF and longer-term cardiovascular disease risk in a group of white men. Although, more research is required, this study raises an important question as to whether CRF should be considered in the design of future UK long-term cardiovascular disease risk equations. Journal Article The Lancet 390 S40 0140-6736 30 11 2017 2017-11-30 10.1016/S0140-6736(17)32975-6 COLLEGE NANME Sport and Exercise Sciences COLLEGE CODE STSC Swansea University 2017-11-28T12:52:41.8196199 2017-11-28T12:49:34.0355422 Faculty of Science and Engineering School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences Benjamin J Gray 1 Jeffrey W Stephens 2 Michael Thomas 3 Sally P Williams 4 Christine A Davies 5 Richard Bracken 0000-0002-6986-6449 6
title Role of cardiorespiratory fitness in lifetime cardiovascular risk prediction models: a cross-sectional analysis
spellingShingle Role of cardiorespiratory fitness in lifetime cardiovascular risk prediction models: a cross-sectional analysis
Richard Bracken
title_short Role of cardiorespiratory fitness in lifetime cardiovascular risk prediction models: a cross-sectional analysis
title_full Role of cardiorespiratory fitness in lifetime cardiovascular risk prediction models: a cross-sectional analysis
title_fullStr Role of cardiorespiratory fitness in lifetime cardiovascular risk prediction models: a cross-sectional analysis
title_full_unstemmed Role of cardiorespiratory fitness in lifetime cardiovascular risk prediction models: a cross-sectional analysis
title_sort Role of cardiorespiratory fitness in lifetime cardiovascular risk prediction models: a cross-sectional analysis
author_id_str_mv f5da81cd18adfdedb2ccb845bddc12f7
author_id_fullname_str_mv f5da81cd18adfdedb2ccb845bddc12f7_***_Richard Bracken
author Richard Bracken
author2 Benjamin J Gray
Jeffrey W Stephens
Michael Thomas
Sally P Williams
Christine A Davies
Richard Bracken
format Journal article
container_title The Lancet
container_volume 390
container_start_page S40
publishDate 2017
institution Swansea University
issn 0140-6736
doi_str_mv 10.1016/S0140-6736(17)32975-6
college_str Faculty of Science and Engineering
hierarchytype
hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences
document_store_str 0
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description BackgroundDespite well-established associations between cardiorespiratory fitness (CRF) and long-term cardiovascular disease risk, CRF remains underused in clinical practice. With a growing emphasis on longer-term risk, developments to UK cardiovascular disease risk equations such as the Joint British Societies' 3 (JBS3) calculator now see the prediction of both lifetime and short-term risk. However, unlike the US LifetimeRisk model, the JBS3 algorithm does not include CRF as a risk variable. The aim of this study was to examine whether differences in CRF values are reflected in long-term cardiovascular disease risk prediction scores using a risk equation that includes CRF in the design (LifetimeRisk) and one that does not (JBS3).MethodsA retrospective, cross-sectional analysis was performed on 81 male steelworkers who participated in the second phase of the Prosiect Sir Gâr workplace-based cardiovascular disease risk assessment initiative in Carmarthenshire, Wales. CRF was calculated with a validated and reliable submaximal protocol based on heart rate responses (Chester Step Test). Between-group CRF differences (excellent or good vs average or below average) were determined by independent sample t test or Mann-Whitney U test, and any association between CRF and individual risk scores investigated by Pearson's correlation.FindingsMen in the lower CRF categories had greater body-mass index scores than men in the higher CRF categories (p=0·001); and less desirable blood lipid profiles with higher total cholesterol (p=0·041) and non-HDL cholesterol (p=0·019) concentrations. The predicted long-term cardiovascular disease risk in the LifetimeRisk model was also greater in the lower fitness group than higher fitness group (mean 13·6% [SD 2·9] vs 7·2 [1·9], p<0·0001), and a negative correlation was evident between individual CRF values and predicted risk scores (r=–0·603, p<0·0001). However, there were no differences between CRF groups in predicted JBS3 lifetime risk (median 79 years [IQR 77–80] vs 79 [78–80], p=0·354).InterpretationThese preliminary observations demonstrate that the LifetimeRisk prediction scores more accurately represent the current literature between CRF and longer-term cardiovascular disease risk in a group of white men. Although, more research is required, this study raises an important question as to whether CRF should be considered in the design of future UK long-term cardiovascular disease risk equations.
published_date 2017-11-30T03:46:37Z
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