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

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journal contribution
posted on 2020-02-28, 15:07 authored by Stavroula Argyridou, Francesco Zaccardi, Melanie J Davies, Kamlesh Khunti, Thomas Yates
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.

History

Citation

European Journal of Preventive Cardiology, https://doi.org/10.1177/2047487319887281

Author affiliation

Diabetes Research Centre, College of Life Sciences

Version

  • AM (Accepted Manuscript)

Published in

European Journal of Preventive Cardiology

Publisher

SAGE Publications

issn

2047-4873

eissn

2047-4881

Copyright date

2019

Available date

2019-10-17

Publisher version

https://journals.sagepub.com/doi/10.1177/2047487319887281

Spatial coverage

England

Language

English