Lancaster Medical School, Faculty of Health and Medicine, Furness College, Lancaster University, Lancaster, UK.
Sport, Exercise and Health Sciences, School of Life Sciences, Faculty of Health Sciences, University of Hull, Hull, UK.
Scand J Med Sci Sports. 2019 Sep;29(9):1402-1413. doi: 10.1111/sms.13468. Epub 2019 Jun 6.
Development of cardiovascular disease (CVD) remains a public health concern for young to middle-aged adults, now exacerbated by the increasing prevalence of obesity and sedentary lifestyles. Cardiorespiratory fitness (CRF) improves the reclassification of short-term (10-year) CVD risk, but has not been uniformly defined across studies. This study evaluated cross-sectional differences in short-term and lifetime CVD risk scores, across both absolute metabolic equivalent (MET) and sex- and age-standardized CRF categories in 805 apparently healthy young to middle-aged adults (68% male; 47.4 ± 7.2 years). CVD risk factors were evaluated, and estimated cardiorespiratory fitness (CRF) measurements (METS and peak VO ) were derived from a submaximal Bruce treadmill test. CRF measures also included post-exercise heart rate recovery (HRR) data. Consistent trends showing more favorable risk factor profiles and lower short-term CVD (QRISK2), and CVD mortality (SCORE) scores, associated with higher levels of CRF were evident in both sexes. Lifetime CVD risk (Q-Lifetime) was highest in the lowest CRF categories. Peak VO and HRR following submaximal exercise testing contributed to the variability in short-term and lifetime CVD risk. Global CVD risk predictions were examined across different contemporary CRF classifications with inconsistent findings. Recommended absolute MET and sex- and age-standardized CRF categories were significantly associated with both short-term and lifetime risk of CVD outcomes. However, compared to internationally derived normative CRF standards, cohort-specific CRF categories resulted in markedly different proportion of individuals classified in the "poor" CRF category at higher CVD risk.
心血管疾病（CVD）的发生仍然是中青年人群的公共健康关注点，而肥胖和久坐不动的生活方式日益普遍，使这一问题更加严重。心肺适能（CRF）可改善短期（10 年）CVD 风险的再分类，但各研究之间并未统一定义。本研究评估了 805 名看似健康的中青年（68%为男性；47.4±7.2 岁）在绝对代谢当量（MET）和按性别及年龄校正的 CRF 类别中，短期和终生 CVD 风险评分的横断面差异。评估了 CVD 风险因素，并从亚最大 Bruce 跑步机测试中得出估计的心肺适能（CRF）测量值（MET 和峰值 VO ）。CRF 测量还包括运动后心率恢复（HRR）数据。在两性中均可见到一致的趋势，即具有更有利的风险因素谱和更低的短期 CVD（QRISK2）和 CVD 死亡率（SCORE）评分，与更高水平的 CRF 相关。在最低的 CRF 类别中，终生 CVD 风险（Q-Lifetime）最高。亚最大运动测试后的峰值 VO 和 HRR 对短期和终生 CVD 风险的变异性有贡献。跨不同当代 CRF 分类的全球 CVD 风险预测存在不一致的发现。推荐的绝对 MET 和按性别及年龄校正的 CRF 类别与短期和终生 CVD 风险均显著相关。然而，与国际衍生的正常 CRF 标准相比，特定队列的 CRF 类别导致在更高 CVD 风险下，被归类为“较差”CRF 类别的个体比例明显不同。
