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Walking Speed and Subclinical Atherosclerosis in Healthy Older Adults: The Whitehall Ii Study
  1. Mark Hamer1,*,
  2. Mika Kivimaki1,
  3. Ajay Yerramasu2,
  4. Avijit Lahiri2,
  5. John E Deanfield1,
  6. Michael G Marmot1,
  7. Andrew Steptoe1
  1. 1 University College London, United Kingdom;
  2. 2 Wellington Hospital, United Kingdom
  1. Correspondence to: Mark Hamer, Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, United Kingdom; m.hamer{at}ucl.ac.uk

Abstract

Objective: Extended walking speed is a predictor of incident cardiovascular disease (CVD) in older individuals, but the ability of an objective short-distance walking speed test to stratify the severity of preclinical conditions remains unclear. We examined whether performance in an 8-foot walking speed test is associated with metabolic risk factors and sub-clinical atherosclerosis.

Design: Cross sectional

Setting: Epidemiological cohort

Participants: 530 adults (aged 63± 6 yrs, 50.3% male) from the Whitehall II cohort study with no known history or objective signs of CVD.

Main outcome: Electron beam computed tomography and ultrasound was used to assess the presence and extent of coronary artery calcification (CAC) and carotid intima-media thickness (IMT), respectively.

Results: High levels of CAC (Agatston score>100) were detected in 24% of the sample; the mean IMT was 0.75 (SD 0.15) mm. Participants with no detectable CAC completed the walking course 0.16 seconds (95% CI, 0.04 to 0.28) faster than those with CAC ≥400. Objectively assessed, but not self-reported, faster walking speed was associated with lower risk of high CAC (odds ratio=0.60, 95% CI, 0.40 to 0.96) and lower IMT (β=-0.04, 95% CI, -0.01 to -0.07 mm) in comparison with the slowest walkers (bottom third), after adjusting for conventional risk factors. Faster walking speed was also associated with lower adiposity, C-reactive protein, and LDL cholesterol.

Conclusions: Short distance walking speed is associated with metabolic risk and sub-clinical atherosclerosis in older adults without overt CVD. These data suggest that a non-aerobically challenging walking test reflects the presence of underlying vascular disease.

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