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Walking speed and subclinical atherosclerosis in healthy older adults: the Whitehall II study.

Hamer M, Kivimaki M, Lahiri A, Yerramasu A, Deanfield JE, Marmot MG, Steptoe A - Heart (2009)

Bottom Line: Objectively assessed, but not self-reported, faster walking speed was associated with a lower risk of high CAC (odds ratio 0.62, 95% CI 0.40 to 0.96) and lower IMT (beta=-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 low-density lipoprotein cholesterol.These data suggest that a non-aerobically challenging walking test reflects the presence of underlying vascular disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology and Public Health, 1-19 Torrington Place, University College London, London WC1E 6BT, UK. m.hamer@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. This study examined whether performance in an 8-ft walking speed test is associated with metabolic risk factors and subclinical atherosclerosis.

Design: Cross-sectional. Setting Epidemiological cohort.

Participants: 530 adults (aged 63 + or - 6 years, 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 mm (SD 0.15). Participants with no detectable CAC completed the walking course 0.16 s (95% CI 0.04 to 0.28) faster than those with CAC > or = 400. Objectively assessed, but not self-reported, faster walking speed was associated with a lower risk of high CAC (odds ratio 0.62, 95% CI 0.40 to 0.96) and lower IMT (beta=-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 low-density lipoprotein cholesterol.

Conclusions: Short-distance walking speed is associated with metabolic risk and subclinical 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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Related in: MedlinePlus

Time to complete walking test in relation to coronary artery calcium scores. Values are mean±SEM, adjusted for age. White bars represent men, filled bars represent women.
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fig1: Time to complete walking test in relation to coronary artery calcium scores. Values are mean±SEM, adjusted for age. White bars represent men, filled bars represent women.

Mentions: High levels of CAC (Agatston score ≥100) were detected in 24% of the sample. The association between self-reported and objectively assessed walking pace is shown in table 2. Objectively assessed (but not self-reported) faster walking speed was associated with a lower risk of high CAC after adjustment for potential confounders, OR 0.62 (95% CI 0.40 to 0.96) for the fastest (upper two-thirds) versus slowest (bottom third) walkers. Using linear analyses there was a marginal association between the log-transformed Agatston score and continuous walking time (age and sex adjusted β=0.49, 95% CI −0.04 to 1.02), indicating a greater extent of CAC in slower walkers. On average, there was a difference of 0.16 s (95% CI 0.04 to 0.28) in the time to complete the walking course in participants with no detectable CAC compared with those with CAC of 400 or greater (see figure 1). Objectively assessed faster walking speed was also associated with lower IMT (β=−0.034, 95% CI −0.002 to −0.067 mm) in comparison with the slowest walkers (bottom third), after adjusting for age, sex, social status, smoking, SF-36 and conventional risk factors (figure 2). No sex differences were observed in these associations (eg, p=0.64 for sex interaction with walking speed and CAC). High walking variability (top third) was not a significant predictor of CAC (age and sex adjusted OR 1.28, 95% CI 0.76 to 2.18) or IMT (β=−0.008, 95% CI −0.041 to 0.025 mm) in comparison with low walking variability (bottom third).


Walking speed and subclinical atherosclerosis in healthy older adults: the Whitehall II study.

Hamer M, Kivimaki M, Lahiri A, Yerramasu A, Deanfield JE, Marmot MG, Steptoe A - Heart (2009)

Time to complete walking test in relation to coronary artery calcium scores. Values are mean±SEM, adjusted for age. White bars represent men, filled bars represent women.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC2921267&req=5

fig1: Time to complete walking test in relation to coronary artery calcium scores. Values are mean±SEM, adjusted for age. White bars represent men, filled bars represent women.
Mentions: High levels of CAC (Agatston score ≥100) were detected in 24% of the sample. The association between self-reported and objectively assessed walking pace is shown in table 2. Objectively assessed (but not self-reported) faster walking speed was associated with a lower risk of high CAC after adjustment for potential confounders, OR 0.62 (95% CI 0.40 to 0.96) for the fastest (upper two-thirds) versus slowest (bottom third) walkers. Using linear analyses there was a marginal association between the log-transformed Agatston score and continuous walking time (age and sex adjusted β=0.49, 95% CI −0.04 to 1.02), indicating a greater extent of CAC in slower walkers. On average, there was a difference of 0.16 s (95% CI 0.04 to 0.28) in the time to complete the walking course in participants with no detectable CAC compared with those with CAC of 400 or greater (see figure 1). Objectively assessed faster walking speed was also associated with lower IMT (β=−0.034, 95% CI −0.002 to −0.067 mm) in comparison with the slowest walkers (bottom third), after adjusting for age, sex, social status, smoking, SF-36 and conventional risk factors (figure 2). No sex differences were observed in these associations (eg, p=0.64 for sex interaction with walking speed and CAC). High walking variability (top third) was not a significant predictor of CAC (age and sex adjusted OR 1.28, 95% CI 0.76 to 2.18) or IMT (β=−0.008, 95% CI −0.041 to 0.025 mm) in comparison with low walking variability (bottom third).

Bottom Line: Objectively assessed, but not self-reported, faster walking speed was associated with a lower risk of high CAC (odds ratio 0.62, 95% CI 0.40 to 0.96) and lower IMT (beta=-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 low-density lipoprotein cholesterol.These data suggest that a non-aerobically challenging walking test reflects the presence of underlying vascular disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology and Public Health, 1-19 Torrington Place, University College London, London WC1E 6BT, UK. m.hamer@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. This study examined whether performance in an 8-ft walking speed test is associated with metabolic risk factors and subclinical atherosclerosis.

Design: Cross-sectional. Setting Epidemiological cohort.

Participants: 530 adults (aged 63 + or - 6 years, 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 mm (SD 0.15). Participants with no detectable CAC completed the walking course 0.16 s (95% CI 0.04 to 0.28) faster than those with CAC > or = 400. Objectively assessed, but not self-reported, faster walking speed was associated with a lower risk of high CAC (odds ratio 0.62, 95% CI 0.40 to 0.96) and lower IMT (beta=-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 low-density lipoprotein cholesterol.

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

Show MeSH
Related in: MedlinePlus