Background: Walking speed (WS) is an indicator of health and function in aging and disease. Whether higher WS attenuates the risk of hospitalisation in adults with hypertension (HTN) is unwell known. Aim: To examine the association between WS and long-term all-cause hospitalisation in patients with HTN and cardiovascular disease (CVD). Methods: Hospitalisation was assessed in 1078 patients with HTN (male/female 867/211, aged 64 _ 10 years) 3 years after enrolment in an exercise-based secondary prevention programme. All patients completed a baseline health examination and a 1-km treadmill walk at moderate intensity, perceptually-regulated at 11-13/20 on the Borg Scale. All-cause hospitalisation was assessed as function of the WS during the 1-km moderate walk. Results: At baseline subjects were subdivided into three groups based on WS: SLOW (2.6 _ 0.5 km/h, n = 359), INTERMEDIATE (3.9 _ 0.3 km/h, n = 362), and FAST (5.1 _ 0.5 km/ h, n = 357). During the following 3 years all-cause hospitalisations were 182 for SLOW (50% of the sample), 160 for INTERMEDIATE (44% of the sample), and 110 for FAST (31% of the sample). Compared to the SLOW group, the fully-adjusted hazard ratios for hospitalisation were 0.97 (95% CI 0.75 to 1.24, p = 0.78) for the INTERMEDIATE, and 0.63 (95% CI 0.45 to 0.88, p < 0.001) for the FAST groups (P for trend < 0.01). Each additional 1 km/h in WS resulted in a 19% reduction in overall hospitalization (HR 0.81, 95% CI 0.71 to 0.91, p < 0.001). Length of hospital stay was 4186 days for SLOW (23 days per person); 2240 for INTERMEDIATE (14 days per person), and 990 days for FAST (9 days per person). Conclusion: The walking speed maintained during a moderate 1-km walk was inversely related to all-cause hospitalisation in patients with HTN and cardiovascular disease. The higher the baseline walking speed, the lower the relative risk of hospitalisation, and the shorter the length of hospital stay.
Moderate walking speed predicts 3-years hospitalisation in hypertensive patients with cardiovascular disease
C MerloPrimo
;B Sassone;S Mandini;F Conconi;G Mazzoni;G GrazziUltimo
2018
Abstract
Background: Walking speed (WS) is an indicator of health and function in aging and disease. Whether higher WS attenuates the risk of hospitalisation in adults with hypertension (HTN) is unwell known. Aim: To examine the association between WS and long-term all-cause hospitalisation in patients with HTN and cardiovascular disease (CVD). Methods: Hospitalisation was assessed in 1078 patients with HTN (male/female 867/211, aged 64 _ 10 years) 3 years after enrolment in an exercise-based secondary prevention programme. All patients completed a baseline health examination and a 1-km treadmill walk at moderate intensity, perceptually-regulated at 11-13/20 on the Borg Scale. All-cause hospitalisation was assessed as function of the WS during the 1-km moderate walk. Results: At baseline subjects were subdivided into three groups based on WS: SLOW (2.6 _ 0.5 km/h, n = 359), INTERMEDIATE (3.9 _ 0.3 km/h, n = 362), and FAST (5.1 _ 0.5 km/ h, n = 357). During the following 3 years all-cause hospitalisations were 182 for SLOW (50% of the sample), 160 for INTERMEDIATE (44% of the sample), and 110 for FAST (31% of the sample). Compared to the SLOW group, the fully-adjusted hazard ratios for hospitalisation were 0.97 (95% CI 0.75 to 1.24, p = 0.78) for the INTERMEDIATE, and 0.63 (95% CI 0.45 to 0.88, p < 0.001) for the FAST groups (P for trend < 0.01). Each additional 1 km/h in WS resulted in a 19% reduction in overall hospitalization (HR 0.81, 95% CI 0.71 to 0.91, p < 0.001). Length of hospital stay was 4186 days for SLOW (23 days per person); 2240 for INTERMEDIATE (14 days per person), and 990 days for FAST (9 days per person). Conclusion: The walking speed maintained during a moderate 1-km walk was inversely related to all-cause hospitalisation in patients with HTN and cardiovascular disease. The higher the baseline walking speed, the lower the relative risk of hospitalisation, and the shorter the length of hospital stay.File | Dimensione | Formato | |
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