Title

CARDIORESPIRATORY FITNESS AND INCIDENT STROKE TYPES: THE FIT (HENRY FORD EXERCISE TESTING) PROJECT

Document Type

Conference Proceeding

Publication Date

2019

Publication Title

J Am Coll Cardiol

Abstract

Background: Cardiorespiratory fitness (CRF) is a strong predictor of mortality and coronary heart disease. This study further examines the association between CRF and incident stroke types. Methods: We studied a retrospective cohort of 67,707 patients referred for treadmill stress testing in the Henry Ford Health System (FIT Project) without a prior history of stroke. CRF was estimated by metabolic equivalents of task (METs). Using appropriate ICD-9 codes, incident stroke was ascertained through linkage with administrative claims files and classified as ischemic (IS), hemorrhagic (HS), and subarachnoid hemorrhage (SAH). Multivariable-adjusted Cox proportional hazards models examined the association between CRF and incident stroke. Results: Mean age was 54 (13) years, 46% were women, and 64% white. After a median (IQR) follow up to 5.6 (2.9–8.8) years, a total of 7,569 incident strokes occurred (6362 IS, 2498 HS, 275 SAH). Overall, there was a graded lower incidence of outcomes with higher METs categories. In adjusted analyses, there was a stepwise and significant lower risk of IS and HS, but not SAH. Participants with METs ≥12 had approximately 60% lower risk of total stroke, IS, and HS compared to METs >6 [HR (95% CI) 0.42 (0.36, 0.49), 0.41 (0.34,0.49) and 0.36 (0.27,0.48) respectively] (Figure). Conclusion: In a large, diverse cohort of patients referred for treadmill stress testing, and independent of traditional cardiovascular risk factors, CRF was inversely associated with incident IS and HS. [Figure presented]

Volume

73

Issue

9

First Page

1697

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