A five-minute treadmill test can predict the risk of mortality, independent of other traditional risk factors including age, weight, blood pressure, smoking status, diabetes, cholesterol, and family history.
Overwhelming evidence has shown a maximal fitness test is a reliable way to determine the risk of mortality. This established test, performed on a treadmill where the maximum incline is steadily increased until the participant cannot continue, isn't commonly used in clinical settings as it's time-intensive and uncomfortable for the patient.
Queen's University, Canada researcher Louise de Lannoy has determined that findings show a shorter treadmill test, called a submaximal fitness test, predicts the risk of premature death similarly to the maximal test. This is an important finding as it provides the clinician with options for assessing the health and risk of their patient.
"This study shows that the risk association with submaximal fitness is similar to that of maximal fitness, which suggests that the submaximal fitness test, which requires less than one-third the time of a maximal fitness test and does not require the patient to reach maximal exertion, is a pragmatic alternative to maximal fitness tests for assessing mortality risk in clinical settings," explains de Lannoy. "Finally, submaximal fitness predicted mortality risk above and beyond traditional risk factors, therefore this test provides information that influences and enhances patient management."
To determine the results, the research team used data from a large study of 6,106 men and women, followed from 1974-2002 to look at change in submaximal test performance over time and its relationship to risk of premature death.
Other members of the research team included Mei Sui (University of South Carolina), Carl J Lavie (John Ochsner Heart and Vascular Institute), Steven N Blair (University of South Carolina), and Robert Ross (Queen's).
Abstract
Objective: To evaluate the relationship between change in submaximal cardiorespiratory fitness (sCRF) and all-cause mortality risk in adult men and women.
Patients and Methods: A prospective study with at least 2 clinical visits (mean follow-up time, 4.2±3.0 years) between April 1974 and January 2002 was conducted to assess the relationship between change in sCRF and mortality risk during follow-up. Participants were 6106 men and women. Submaximal CRF was determined using the heart rate obtained at the 5-minute mark of a graded maximal treadmill test used to determine maximal CRF (mCRF). Change in sCRF from baseline to follow-up was categorized into 3 groups: increased fitness (decreased heart rate, <−4.0 beats/min), stable fitness (heart rate, −4.0 to 3.0 beats/min), and decreased fitness (increased heart rate, >3.0 beats/min).
Results: The mean change in sCRF at follow-up for all 6106 study participants was −0.5±10.0 beats/min, and the mean change in mCRF was −0.3±1.4 metabolic equivalents. Change in sCRF was related to change in mCRF, though the variance explained was small (R2=0.21; P<.001). The hazard ratios (95% CIs) for all-cause mortality were 0.60 (0.38-0.96) for stable and 0.59 (0.35-1.00) for increased sCRF compared with decreased sCRF after adjusting for age, change in weight, and other common risk factors for premature mortality. The hazard ratios for changes in sCRF and mCRF were not significant after adjusting for changes in mCRF (P=.29) and sCRF (P=.60), respectively.
Conclusion: A simple 5-minute submaximal test of CRF identified that adults who maintained or improved sCRF were less likely to die from all causes during follow-up than were adults whose sCRF decreased.
Authors
Louise de Lannoy, Xuemei Sui, Carl J Lavie, Steven N Blair, Robert Ross
[link url="http://www.queensu.ca/gazette/media/news-release-new-research-shows-shorter-fitness-test-still-accurately-predicts-risk-mortality"]Queen’s University material[/link]
[link url="http://www.mayoclinicproceedings.org/article/S0025-6196(17)30846-7/fulltext"]Mayo Clinic Proceedings abstract[/link]