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. 2022 Jan 3;19(1):510.
doi: 10.3390/ijerph19010510.

Adding Estimated Cardiorespiratory Fitness to the Framingham Risk Score and Mortality Risk in a Korean Population-Based Cohort Study

Inhwan Lee  1 , Jeonghyeon Kim  1 , Hyunsik Kang  1
Affiliations

Adding Estimated Cardiorespiratory Fitness to the Framingham Risk Score and Mortality Risk in a Korean Population-Based Cohort Study

Inhwan Lee et al. Int J Environ Res Public Health. .

Abstract

Background: The added value of non-exercise-based estimation of cardiorespiratory fitness (eCRF) to cardiovascular disease (CVD) risk factors for mortality risk has not been examined in Korean populations.

Methods: This population-based prospective cohort study examined the relationship of the 10-year Framingham risk score (FRS) for CVD risk and eCRF with all-cause and CVD mortality in a representative sample of Korean adults aged 30 years and older. Data regarding a total of 38,350 participants (16,505 men/21,845 women) were obtained from the 2007-2015 Korea National Health and Nutrition Examination Survey (KNHANES). All-cause and CVD mortality were the main outcomes. The 10-year FRS point sum and eCRF level were the main exposures.

Results: All-cause and CVD mortality was positively correlated with the 10-year FRS point summation and inversely correlated with eCRF level in this study population. The protective of high eCRF against all-cause and CVD mortality was more prominent in the middle and high FRS category than in the low FRS category. Notably, the FRS plus eCRF model has better predictor power for estimating mortality risk compared to the FRS only model.

Conclusions: The current findings indicate that eCRF can be used as an alternative to objectively measured CRF for mortality risk prediction.

Keywords: Framingham risk score; Koreans; cardiorespiratory fitness; cardiovascular disease; mortality.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A flow chart of selection of study participants.
Figure 2
Figure 2
The Kaplan–Meier survival curves for all-cause and cardiovascular disease (CVD) mortality by estimated cardiorespiratory fitness (eCRF) and 10-yr Framingham risk score (FRS): (a) eCRF and all-cause mortality; (b) eCRF and CVD mortality; (c) FRS and all-cause mortality, and (d) FRS and CVD mortality.
Figure 3
Figure 3
Receiver operating characteristic curve (AUC) comparing the predictive ability of the Framingham risk score (FRS) (Model A) compared to the FRS plus estimated cardiorespiratory fitness (eCRF) (Model B).
See this image and copyright information in PMC

References

    1. World Health Organization Fact Sheets; Cardiovascular Diseases (CVDs) 2021. [(accessed on 11 June 2021)]. Available online: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases...
    1. Barlow C.E., Defina L.F., Radford N.B., Berry J.D., Cooper K.H., Haskell W.L., Jones L.W., Lakoski S.G. Cardiorespiratory fitness and long-term survival in “low-risk” adults. J. Am. Heart Assoc. 2021;1:e001354. doi: 10.1161/JAHA.112.001354. - DOI - PMC - PubMed
    1. Rawshani A., Rawshani A., Rawshani A., Franzén S., Sattar N., Eliasson B., Svensson A.M., Zethelius B., Miftaraj M., McGuire D.K., et al. Risk factors, mortality, and cardiovascular outcomes in patients with type 2 diabetes. N. Engl. J. Med. 2018;379:633–644. doi: 10.1056/NEJMoa1800256. - DOI - PubMed
    1. Kim S.M., Kim S.M., Lee G., Choi S., Kim K., Jeong S.M., Son J.S., Yun J.M., Kim S.G., Hwang S.S., et al. Association of early-onset diabetes, prediabetes and early glycaemic recovery with the risk of all-cause and cardiovascular mortality. Diabetologia. 2020;63:2305–2314. doi: 10.1007/s00125-020-05252-y. - DOI - PubMed
    1. Li T.C., Li C.I., Liu C.S., Lin W.Y., Lin C.H., Yang S.Y., Lin C.C. Derivation and validation of 10-year all-cause and cardiovascular disease mortality prediction model for middle-aged and elderly community-dwelling adults in Taiwan. PLoS ONE. 2020;15:e0239063. doi: 10.1371/journal.pone.0239063. - DOI - PMC - PubMed

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