Policy, Research and International Development, Public Health Wales, Cardiff CF10 4BZ, UK,
Diabetes Research Group, College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK.
Occup Med (Lond). 2017 Jan;67(1):38-43. doi: 10.1093/occmed/kqw131. Epub 2016 Oct 1.
The workplace has been advocated as a setting to perform cardiovascular disease (CVD) risk assessments. These risk assessments usually focus on traditional risk factors rather than cardiorespiratory fitness (CRF) despite established associations between CRF and CVD. The lack of guidance on interpreting health-related CRF values has been suggested as a barrier to utilizing CRF in practice.
To assess the merits of CRF testing in the workplace and explore whether a CRF value identified male individuals above the recommended threshold for further clinical investigation.
Cross-sectional analysis of male steelworkers from Carmarthenshire, South Wales, UK who completed a workplace-based CVD risk assessment with an added CRF protocol based on heart rate responses (Chester Step Test). Receiver operating characteristic (ROC) analysis was undertaken to explore the possibility of a CRF value to identify individuals at an increased 10-year risk of CVD (QRISK2 ≥ 10%).
There were 81 participants. ROC analysis revealed that a CRF level of 34.5ml/kg/min identified those individuals above the ≥10% QRISK2 threshold with the best sensitivity (0.800) and specificity (0.687) to discriminate against true- and false-positive rates. Further analysis revealed that individuals with either 'Average' or 'Below Average' CRF would be five times more likely to have a 10-year CVD risk above the ≥10% QRISK2 threshold than individuals with an 'Excellent' or 'Good' level of fitness [OR 5.10 (95% CI 1.60-16.3)].
This study suggests CRF assessments are a useful addition to a workplace CVD assessment and could identify male individuals at increased predicted risk of the condition.
工作场所已被提倡作为进行心血管疾病（CVD）风险评估的场所。这些风险评估通常侧重于传统的风险因素，而不是心肺功能（CRF），尽管 CRF 与 CVD 之间存在明确的关联。有人认为，缺乏关于解释与健康相关的 CRF 值的指导，是在实践中利用 CRF 的障碍。
评估在工作场所进行 CRF 测试的优点，并探讨是否存在一个 CRF 值可以识别出男性个体，其 CRF 值高于推荐的进一步临床调查阈值。
对英国南威尔士卡马森郡的男性钢铁工人进行横断面分析，这些工人在工作场所进行了 CVD 风险评估，并根据心率反应（切斯特台阶测试）增加了 CRF 方案。进行了接收者操作特征（ROC）分析，以探讨 CRF 值是否有可能识别出 CVD 风险增加 10 年的个体（QRISK2≥10%）。
共有 81 名参与者。ROC 分析显示，CRF 水平为 34.5ml/kg/min 可以最佳地识别出那些 QRISK2≥10%的个体，其敏感性（0.800）和特异性（0.687）最高，以区分真阳性和假阳性率。进一步分析显示，CRF 水平为“平均”或“低于平均”的个体比 CRF 水平为“优秀”或“良好”的个体发生 CVD 风险 10 年风险超过 QRISK2≥10%的可能性高 5 倍[OR 5.10（95%CI 1.60-16.3）]。
这项研究表明，CRF 评估是工作场所 CVD 评估的有用补充，可以识别出 CVD 风险增加的男性个体。
