Treadmill walking speed and survival prediction in men with cardiovascular disease: a 10-year follow-up study
Open Access
- 25 October 2013
- Vol. 3 (10), e003446
- https://doi.org/10.1136/bmjopen-2013-003446
Abstract
Objective To determine whether the walking speed maintained during a 1 km treadmill test at moderate intensity predicts survival in patients with cardiovascular disease. Design Population-based prospective study. Setting Outpatient secondary prevention programme in Ferrara, Italy. Participants 1255 male stable cardiac patients, aged 25–85 years at baseline. Main outcome measures Walking speed maintained during a 1 km treadmill test, measured at baseline and mortality over a median follow-up of 8.2 years. Results Among 1255 patients, 141 died, for an average annual mortality of 1.4%. Of the variables considered, the strongest predictor of all-cause mortality was walking speed (95% CI 0.45 to 0.75, p<0.0001). Based on the average speed maintained during the test, participants were subdivided into quartiles and mortality risk adjusted for confounders was calculated. Compared to the slowest quartile (average walking speed 3.4 km/h), the relative mortality risk decreased for the second, third and fourth quartiles (average walking speed 5.5 km/h), with HRs of 0.73 (95% CI 0.46 to 1.18); 0.54 (95% CI 0.31 to 0.95) and 0.20 (95% CI 0.07 to 0.56), respectively (p for trend <0.0001). Receiver operating curve analysis showed an area under the curve of 0.71 (p<0.0001) and the highest Youden index (0.35) for a walking speed of 4.0 km/h. Conclusions The average speed maintained during a 1 km treadmill walking test is inversely related to survival in patients with cardiovascular disease and is a simple and useful tool for stratifying risk in patients undergoing secondary prevention and cardiac rehabilitation programmes.Keywords
This publication has 34 references indexed in Scilit:
- Assessment of Functional Capacity in Clinical and Research SettingsCirculation, 2007
- Exercise Capacity and Mortality among Men Referred for Exercise TestingNew England Journal of Medicine, 2002
- A Qualitative Systematic Overview of the Measurement Properties of Functional Walk Tests Used in the Cardiorespiratory DomainSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2001
- Comparison of Hallway and Treadmill Six-minute Walk TestsAmerican Journal of Respiratory and Critical Care Medicine, 1999
- Objective assessment of the response to treatment of severe heart failure using a 9-minute walk test on a patient-powered treadmillJournal of Cardiac Failure, 1996
- Estimation of peak oxygen consumption from a sub-maximal half mile walk in obese females.1992
- A 2-km Walking Test for Assessing the Cardiorespiratory Fitness of Healthy AdultsInternational Journal of Sports Medicine, 1991
- Reproducibility of walking test results in chronic obstructive airways disease.Thorax, 1988
- Estimation of VO2max from a one-mile track walk, gender, age, and body weight.1987
- The 100 m walk: a simple and reproducible exercise test.1984