Walking speed and subclinical atherosclerosis in healthy older adults: the Whitehall II study. Issue 5 (1st December 2009)

• Record Type: Journal Article
• Authors: Hamer, Mark; Kivimaki, Mika; Lahiri, Avijit; Yerramasu, Ajay; Deanfield, John E; Marmot, Michael G; Steptoe, Andrew
• Is Part Of: Heart. Volume 96:Issue 5(2010)
• Page Start: 380
• Page End: 384
• Publication Date: 2009-12-01
• Subjects: Ageing -- atherosclerosis -- computed tomography scanning -- epidemiology -- exercise testing -- gait speed -- imaging -- physical function -- risk stratification; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.2009.183350
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objective: Extended walking speed is a predictor of incident cardiovascular disease (CVD) in older individuals, but the ability of an objective short-distance walking speed test to stratify the severity of preclinical conditions remains unclear. This study examined whether performance in an 8-ft walking speed test is associated with metabolic risk factors and subclinical atherosclerosis. Design: Cross-sectional. Setting: Epidemiological cohort. Participants: 530 adults (aged 63±6 years, 50.3% male) from the Whitehall II cohort study with no known history or objective signs of CVD. Main outcome: Electron beam computed tomography and ultrasound was used to assess the presence and extent of coronary artery calcification (CAC) and carotid intima-media thickness (IMT), respectively. Results: High levels of CAC (Agatston score >100) were detected in 24% of the sample; the mean IMT was 0.75 mm (SD 0.15). Participants with no detectable CAC completed the walking course 0.16 s (95% CI 0.04 to 0.28) faster than those with CAC ≥400. Objectively assessed, but not self-reported, faster walking speed was associated with a lower risk of high CAC (odds ratio 0.62, 95% CI 0.40 to 0.96) and lower IMT (β=−0.04, 95% CI −0.01 to −0.07 mm) in comparison with the slowest walkers (bottom third), after adjusting for conventional risk factors. Faster walking speed was also associated with lower adiposity, C-reactive protein and low-density lipoprotein cholesterol. Conclusions: Short-distance walking speed is associated with metabolic risk and subclinical atherosclerosis in older adults without overt CVD. These data suggest that a non-aerobically challenging walking test reflects the presence of underlying vascular disease.