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Use of functional aerobic capacity based on stress testing to predict outcomes in normal, overweight, and obese patients.
Mayo Clin Proc. 2013 Dec; 88(12):1427-34.MC

Abstract

OBJECTIVE

To determine the poorly studied relationship between functional aerobic capacity (FAC) as measured by treadmill stress testing and mortality in normal, overweight, and obese patients.

PATIENTS AND METHODS

Patients were identified retrospectively from the stress testing database at Mayo Clinic in Rochester, Minnesota. We selected 5328 male nonsmokers (mean ± SD age, 51.8±11.5 years) without baseline cardiovascular disease who were referred for treadmill exercise testing between January 1, 1986, and December 31, 1991, and classified them by body mass index (BMI) into normal-weight (18.5-24.9 kg/m(2)), overweight (25.0-29.9 kg/m(2)), and obese (≥30 kg/m(2)) categories. Functional aerobic capacity was assessed by maximal exercise test results based on age- and sex-specific metabolic equivalents, and patients were stratified into fitness quintiles. Cox proportional hazards analysis was used to determine the relationship of all-cause mortality to fitness in each BMI category.

RESULTS

There were 322 deaths during 14 years of follow-up. After adjustment for age and exercise confounders, FAC predicted mortality in the 3 BMI groups. Hazard ratios for FAC less than 80% of predicted vs a reference group with normal BMI and fitness (FAC ≥100%) were 1.754 (95% CI, 0.874-3.522), 1.962 (1.356-2.837), and 1.518 (1.056-2.182) for the normal, overweight, and obese groups, respectively. The CIs of the hazard ratios overlapped with no statistically significant differences (P>.05).

CONCLUSION

A significant increase in mortality occurs with FAC below 80% of predicted for overweight and obese subjects and below 70% for normal weight subjects. Our results suggest that clinicians need not adjust the standard for low fitness in obese patients.

Authors+Show Affiliations

Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24290116

Citation

Abudiab, Muaz, et al. "Use of Functional Aerobic Capacity Based On Stress Testing to Predict Outcomes in Normal, Overweight, and Obese Patients." Mayo Clinic Proceedings, vol. 88, no. 12, 2013, pp. 1427-34.
Abudiab M, Aijaz B, Konecny T, et al. Use of functional aerobic capacity based on stress testing to predict outcomes in normal, overweight, and obese patients. Mayo Clin Proc. 2013;88(12):1427-34.
Abudiab, M., Aijaz, B., Konecny, T., Kopecky, S. L., Squires, R. W., Thomas, R. J., & Allison, T. G. (2013). Use of functional aerobic capacity based on stress testing to predict outcomes in normal, overweight, and obese patients. Mayo Clinic Proceedings, 88(12), 1427-34. https://doi.org/10.1016/j.mayocp.2013.10.013
Abudiab M, et al. Use of Functional Aerobic Capacity Based On Stress Testing to Predict Outcomes in Normal, Overweight, and Obese Patients. Mayo Clin Proc. 2013;88(12):1427-34. PubMed PMID: 24290116.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of functional aerobic capacity based on stress testing to predict outcomes in normal, overweight, and obese patients. AU - Abudiab,Muaz, AU - Aijaz,Bilal, AU - Konecny,Tomas, AU - Kopecky,Stephen L, AU - Squires,Ray W, AU - Thomas,Randal J, AU - Allison,Thomas G, PY - 2013/06/26/received PY - 2013/10/14/revised PY - 2013/10/15/accepted PY - 2013/12/3/entrez PY - 2013/12/3/pubmed PY - 2014/1/28/medline KW - BMI KW - CVD KW - ECG KW - FAC KW - HR KW - MET KW - body mass index KW - cardiovascular disease KW - electrocardiography KW - functional aerobic capacity KW - hazard ratio KW - metabolic equivalent SP - 1427 EP - 34 JF - Mayo Clinic proceedings JO - Mayo Clin Proc VL - 88 IS - 12 N2 - OBJECTIVE: To determine the poorly studied relationship between functional aerobic capacity (FAC) as measured by treadmill stress testing and mortality in normal, overweight, and obese patients. PATIENTS AND METHODS: Patients were identified retrospectively from the stress testing database at Mayo Clinic in Rochester, Minnesota. We selected 5328 male nonsmokers (mean ± SD age, 51.8±11.5 years) without baseline cardiovascular disease who were referred for treadmill exercise testing between January 1, 1986, and December 31, 1991, and classified them by body mass index (BMI) into normal-weight (18.5-24.9 kg/m(2)), overweight (25.0-29.9 kg/m(2)), and obese (≥30 kg/m(2)) categories. Functional aerobic capacity was assessed by maximal exercise test results based on age- and sex-specific metabolic equivalents, and patients were stratified into fitness quintiles. Cox proportional hazards analysis was used to determine the relationship of all-cause mortality to fitness in each BMI category. RESULTS: There were 322 deaths during 14 years of follow-up. After adjustment for age and exercise confounders, FAC predicted mortality in the 3 BMI groups. Hazard ratios for FAC less than 80% of predicted vs a reference group with normal BMI and fitness (FAC ≥100%) were 1.754 (95% CI, 0.874-3.522), 1.962 (1.356-2.837), and 1.518 (1.056-2.182) for the normal, overweight, and obese groups, respectively. The CIs of the hazard ratios overlapped with no statistically significant differences (P>.05). CONCLUSION: A significant increase in mortality occurs with FAC below 80% of predicted for overweight and obese subjects and below 70% for normal weight subjects. Our results suggest that clinicians need not adjust the standard for low fitness in obese patients. SN - 1942-5546 UR - https://www.unboundmedicine.com/medline/citation/24290116/Use_of_functional_aerobic_capacity_based_on_stress_testing_to_predict_outcomes_in_normal_overweight_and_obese_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0025-6196(13)00891-4 DB - PRIME DP - Unbound Medicine ER -