Walking pace improves all-cause and cardiovascular mortality risk prediction: A UK Biobank prognostic study
- 7 November 2019
- journal article
- research article
- Published by Oxford University Press (OUP) in European Journal of Preventive Cardiology
- Vol. 27 (10), 1036-1044
- https://doi.org/10.1177/2047487319887281
Abstract
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). 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). 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. 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.Keywords
This publication has 37 references indexed in Scilit:
- Genetic, Physiological, and Lifestyle Predictors of Mortality in the General PopulationAmerican Journal of Public Health, 2012
- Dose Response Between Physical Activity and Risk of Coronary Heart DiseaseCell Metabolism, 2011
- How to calculate vascular age with the SCORE project scales: a new method of cardiovascular risk evaluationEuropean Heart Journal, 2010
- Cardiorespiratory Fitness as a Quantitative Predictor of All-Cause Mortality and Cardiovascular Events in Healthy Men and WomenJAMA, 2009
- Criteria for Evaluation of Novel Markers of Cardiovascular RiskCirculation, 2009
- Adherence to Mediterranean diet and health status: meta-analysisBMJ, 2008
- Association of physical activity with all-cause and cardiovascular mortality: a systematic review and meta-analysisEuropean Journal of Preventive Cardiology, 2008
- General Cardiovascular Risk Profile for Use in Primary CareCirculation, 2008
- Walking and primary prevention: a meta-analysis of prospective cohort studiesBritish Journal of Sports Medicine, 2007
- Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE projectEuropean Heart Journal, 2003