Exercise capacity and mortality - a follow-up study of 3033 subjects referred to clinical exercise testing

• Published in: Annals of medicine (Helsinki) Vol. 48; no. 5; p. 359
• Main Authors: Korpelainen, Raija, Lämsä, Jenni, Kaikkonen, Kaisu M, Korpelainen, Juha, Laukkanen, Jari, Palatsi, Ilkka, Takala, Timo E, Ikäheimo, Tiina M, Hautala, Arto J
• Format: Journal Article
• Language: English
• Published: England 03.07.2016
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Cardiovascular Diseases - mortality; Cardiovascular Diseases - physiopathology; Cause of Death; Exercise Test; Exercise Tolerance; Female; Follow-Up Studies; Heart Rate; Humans; Male; Middle Aged; Proportional Hazards Models; Young Adult; Exercise; physical fitness; men; mortality; prevention & control; exercise test; women
• ISSN: 1365-2060
• DOI: 10.1080/07853890.2016.1178856

Exercise stress testing is used as a diagnostic and prognostic tool. We determined the prognostic significance of exercise test findings for cardiovascular (CVD) and all-cause mortality in men and women. 3033 subjects underwent a symptom-limited bicycle exercise test. Exercise capacity was defined as the mean of last four minutes of exercise workload. During an average follow-up of 19 years, 186 (11.6%) CVD and 370 (20.6%) all-cause deaths in men and 57 (5.0%) CVD and 155 (12.5%) all-cause deaths in women occurred. Among exercise test variables (workload, ECG, BP, HR), exercise capacity was the strongest predictor of mortality. Low exercise capacity (1st quartile) was associated with a hazard ratio of 4.2 (95% CI: 1.7, 10.8) for CVD and 4.0 (95% CI: 2.5, 6.4) for all-cause mortality compared with high exercise capacity (4th quartile) among men and in women with a 5.4-fold (95% CI: 1.2, 24.0) risk for CVD and 2.3-fold (95% CI: 1.2, 4.3) risk for all-cause mortality, respectively. The relationship between other exercise test variables and mortality was much weaker. Among exercise test variables exercise capacity was the strongest predictor of CVD and all-cause mortality in both genders, and especially CVD deaths in women. Key Messages Exercise capacity was the most powerful predictor of CVD and all-cause mortality in both men and women. Low exercise capacity is a strong predictor of CVD death, especially among women.