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Performance on exercise test predicts risk of death from cardiovascular disease and cancer

December 06, 2018

Milan, Italy - 6 December 2018: Performance on an exercise test predicts the risk of death from cardiovascular disease, cancer, and other causes, reports a study presented today at EuroEcho-Imaging 2018.1 Good performance on the test equates to climbing three floors of stairs very fast, or four floors fast, without stopping. The findings underline the importance of fitness for longevity.

The study included 12,615 participants with known or suspected coronary artery disease. Participants underwent treadmill exercise echocardiography, in which they were asked to walk or run, gradually increasing the intensity, and continue until exhaustion. Watch a video of the technique here. The test also generates images of the heart to check its function.

During a median 4.7-year follow-up, there were 1,253 cardiovascular deaths, 670 cancer deaths, and 650 deaths from other causes. After adjusting for age, sex, and other factors that could potentially influence the relationship, each MET (metabolic equivalent)* achieved was independently associated with 9%, 9%, and 4% lower risks of cardiovascular death, cancer death, and other causes of death during follow-up.

The death rate from cardiovascular disease was nearly three times higher in participants with poor compared to good functional capacity (3.2% versus 1.2%, p<0.001). Non-cardiovascular and non-cancer deaths were also nearly three-fold higher in those with poor compared to good functional capacity (1.7% versus 0.6%, p<0.001). Cancer deaths were almost double in participants with poor compared to good functional capacity (1.5% versus 0.8%, p<0.001).

As expected, the imaging part of the examination was predictive of cardiovascular death, but not of deaths caused by cancer or other conditions.

Study author Dr Jesús Peteiro, a cardiologist at University Hospital A Coruña, A Coruña, Spain, said: "Our results provide further evidence of the benefits of exercise and being fit on health and longevity. In addition to keeping body weight down, physical activity has positive effects on blood pressure and lipids, reduces inflammation, and improves the body's immune response to tumours."

Dr Peteiro said people do not need to undergo exercise echocardiography to check their fitness level. "There are much cheaper ways to estimate if you could achieve ten METs on the treadmill test," he said. "If you can walk very fast up three floors of stairs without stopping, or fast up four floors without stopping, you have good functional capacity. If not, it's a good indication that you need more exercise."

ESC guidelines recommend at least 150 minutes a week of moderate aerobic physical activity or 75 minutes a week of vigorous aerobic physical activity, or a combination of the two intensities.2
-end-
Authors: ESC Press Office

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Notes to editor

SOURCES OF FUNDING: None.

DISCLOSURES: None.

References and notes

* The maximum workload achieved was measured in metabolic equivalents (METs). One MET is the rate of energy expenditure, or oxygen use, while sitting quietly (1 kcal/kg/hour or 3.5 mL/kg/min). Light activities (standing, walking slowly) use less than three METs, moderate-intensity activities (brisk walking) use three to six METs, and vigorous-intensity activities (jogging, playing football) use more than six METs.

In the study, good functional capacity was defined as being able to achieve ten METs during the test. Participants were divided into two groups according to the number of METs achieved during the test: poor functional capacity (less than ten METs) and good functional capacity (ten METs or more).

1The abstract 'Prediction of cardiovascular, cancer and noncardiovascular noncancer death by exercise echocardiography' will be presented during Poster session 3: Stress Echocardiography on 6 December, 14:00 to 18:00 CET in the Poster area.

2Piepoli MF, Hoes AW, Agewall S, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2016;37:2315-2381.

About the European Association of Cardiovascular Imaging (EACVI)

The European Association of Cardiovascular Imaging (EACVI) - a branch of the ESC - is the world leading network of Cardiovascular Imaging (CVI) experts, gathering four imaging modalities under one entity (Echocardiography, Cardiovascular Magnetic Resonance, Nuclear Cardiology and Cardiac Computed Tomography). Its aim is to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging. The EACVI welcomes over 11,000 professionals including cardiologists, sonographers, nurses, basic scientists and allied professionals.

About the European Society of Cardiology

The European Society of Cardiology brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.

Information for journalists attending EuroEcho-Imaging 2018

EuroEcho-Imaging 2018 takes place 5 to 8 December at the MiCo Milano Congressi in Milan, Italy. Explore the scientific programme.

* To register on-site please bring a valid press card or appropriate letter of assignment with proof of three recent published articles (cardiology or health-related, or referring to a previous ESC Event).

European Society of Cardiology

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