Article Text

PDF
Coronary artery disease
Workload at the heart rate of 100 beats/min and mortality in middle-aged men with known or suspected coronary heart disease
  1. K P Savonen1,2,
  2. T A Lakka1,3,
  3. J A Laukkanen1,4,
  4. T H Rauramaa1,
  5. J T Salonen4,5,6,
  6. R Rauramaa1,2
  1. 1
    Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
  2. 2
    Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
  3. 3
    Institute of Biomedicine, Physiology, University of Kuopio, Kuopio, Finland
  4. 4
    School of Public Health and Clinical Nutrition, University of Kuopio, Kuopio, Finland
  5. 5
    Inner Savo Health Centre, Suonenjoki, Finland
  6. 6
    Oy Jurilab Ltd, Kuopio, Finland
  1. Dr K P Savonen, Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, 70100 KUOPIO, Finland; savonen{at}hytti.uku.fi

Abstract

Objective: To investigate whether a workload which an individual is able to perform at the heart rate (HR) of 100 beats/min (WL100) independently predicts mortality in middle-aged men with known or suspected coronary heart disease (CHD).

Design: Prospective population-based study based on 365 middle-aged men with known or suspected CHD at baseline.

Results: During an average follow-up of 11.1 years, there were 75 deaths (20.5%). In Cox multivariable models mortality increased by 72% (95% CI 32% to 122%, p<0.001) with 1 SD (34 Watts) decrement in WL100 after adjustment for age, examination year, alcohol consumption, body mass index, cigarette smoking, cardiac insufficiency, history of myocardial infarction, diabetes, myocardial ischaemia during exercise test, serum low-density lipoprotein and high-density lipoprotein cholesterol, systolic and diastolic blood pressure at rest, testing protocol, and use of HR-lowering medication. The risk of death was 2.4 (95% CI 1.5 to 4.0, p<0.001) times higher in 130 men with WL100 <55 W than in 235 men with WL100 ⩾55 W. In men using and not using HR-lowering medication the risk of death increased 72% (95% CI 14% to 163%, p = 0.01), and 54% (95% CI 14% to 108%, p = 0.005) with 1 SD decrement in WL100, respectively. WL100 improved the predictive power of the adjusted Cox models including other HR and exercise test variables.

Conclusions: WL100 predicts mortality in men with known or suspected CHD. The association of WL100 with mortality was not explained by other well-established HR and exercise test variables. WL100 is derived from a submaximal test which avoids the cardiovascular risks associated with a high-intensity exertion.

Statistics from Altmetric.com

Footnotes

  • Funding: This study was supported by grants from the Ministry of Education in Finland (74/722/2003), the Finnish Cultural Foundation of Northern Savo, the Foundation of Sports Institutes in Finland, the Maire Taponen Foundation, the Mehiläinen Research Foundation, and the Paulo Foundation.

  • Competing interests: None.

  • Contributors: TAL was a Research Fellow of the Academy of Finland. KPS: conception and design; analysis and interpretation of data; drafting of the manuscript; final approval of the manuscript submitted. TAL: conception and design; analysis and interpretation of data; drafting of the manuscript; final approval of the manuscript submitted. JAL: conception and design; analysis and interpretation of data; critically revising the manuscript for important intellectual content; final approval of the manuscript submitted. THR: conception and design; analysis and interpretation of data; critically revising the manuscript for important intellectual content; final approval of the manuscript submitted. JTS: conception and design; critically revising the manuscript for important intellectual content; final approval of the manuscript submitted. RR: conception and design; analysis and interpretation of data; drafting of the manuscript; final approval of the manuscript submitted. KPS is the guarantor.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.