Abstract 2171: The Predictive Value of Cardiorespiratory Fitness for Stroke in Men with Various Risk Profiles: A Prospective Population-Based Cohort Study
Background Few data exist to show if the prognostic value of oxygen consumption (VO2peak) during exercise for stroke is different among men with low and high pre-test probability for cardiovascular disease (CVD). Our objective was to determine whether VO2peak may predict ischemic and any stroke in 2361 men aged 42 to 60 years with and without conventional risk predictors of CVD or with documented CVD during a 15-year follow-up.
Methods and Results Maximal oxygen consumption (mL per kg in minute) was measured directly by using respiratory gas exchange in a cycle ergometer exercise test. Of all 87 strokes, 70 were due to ischemic reasons. One metabolic equivalent (MET) increment in VO2peak was related to a decreased risk of ischemic stroke in both healthy (Relative risk, RR=0.86, 95 % CI 0.75 to 0.99, p= 0.036) and unhealthy (RR=0.82, 95 % CI 0.73 to 0.93, p=0.002) men. Unfit healthy men (<27.6 mL/kg per minute) with 2 or 3 conventional risk factors had the highest risk of ischemic stroke (RR=6.65, 95 % CI 2.23 to 19.81, p=0.001) as compared with most fit men (>37.1 mL/kg per minute) with no or 1 risk factor. The respective risk for unfit men with underlying CVD or pulmonary diseases was 5.36-fold (95 % CI 1.95 to 14.71, p=0.001). VO2peak represented a strong and consistent risk factor for ischemic and any stroke among both health and unhealthy men.
Conclusions VO2peak can be used as a powerful predictor of future stroke comparable to with those predicted by many conventional risk factors. On the prognostic consideration, unfit men with unfavourable risk profile or underlying chronic disease are the risk groups that will benefit most from preventive measures from stroke.