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Eur J Prev Cardiol. 2019 Nov 7:2047487319887281. doi: 10.1177/2047487319887281. [Epub ahead of print]

Walking pace improves all-cause and cardiovascular mortality risk prediction: A UK Biobank prognostic study.

Author information

1
Diabetes Research Centre, University of Leicester, UK.
2
National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University of Leicester, UK.
3
NIHR Applied Research Collaboration East Midlands (ARC EM), University of Leicester, UK.

Abstract

AIMS:

The purpose of this study was to quantify and rank the prognostic relevance of dietary, physical activity and physical function factors in predicting all-cause and cardiovascular mortality in comparison with the established risk factors included in the European Society of Cardiology Systematic COronary Risk Evaluation (SCORE).

METHODS:

We examined the predictive discrimination of lifestyle measures using C-index and R2 in sex-stratified analyses adjusted for: model 1, age; model 2, SCORE variables (age, smoking status, systolic blood pressure, total and high-density lipoprotein cholesterol).

RESULTS:

The sample comprised 298,829 adults (median age, 57 years; 53.5% women) from the UK Biobank free from cancer and cardiovascular disease at baseline. Over a median follow-up of 6.9 years, there were 2174 and 3522 all-cause and 286 and 796 cardiovascular deaths in women and men, respectively. When added to model 1, self-reported walking pace improved C-index in women and men by 0.013 (99% CI: 0.007-0.020) and 0.022 (0.017-0.028) respectively for all-cause mortality; and by 0.023 (0.005-0.042) and 0.034 (0.020-0.048) respectively for cardiovascular mortality. When added to model 2, corresponding values for women and men were: 0.008 (0.003-0.012) and 0.013 (0.009-0.017) for all-cause mortality; and 0.012 (-0.001-0.025) and 0.024 (0.013-0.035) for cardiovascular mortality. Other lifestyle factors did not consistently improve discrimination across models and outcomes. The pattern of results for R2 mirrored those for C-index.

CONCLUSION:

A simple self-reported measure of walking pace was the only lifestyle variable found to improve risk prediction for all-cause and cardiovascular mortality when added to established risk factors.

KEYWORDS:

Walking pace; cardiovascular risk; mortality; prognosis

PMID:
31698963
DOI:
10.1177/2047487319887281

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