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Walking speed and subclinical atherosclerosis in healthy older adults: the Whitehall II study

Hamer, M; Kivimaki, M; Lahiri, A; Yerramasu, A; Deanfield, JE; Marmot, MG; Steptoe, A; (2010) Walking speed and subclinical atherosclerosis in healthy older adults: the Whitehall II study. Heart , 96 (5) 380 - 384. 10.1136/hrt.2009.183350. Green open access

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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 (beta=-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.

Type: Article
Title: Walking speed and subclinical atherosclerosis in healthy older adults: the Whitehall II study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/hrt.2009.183350
Publisher version: http://dx.doi.org/10.1136/hrt.2009.183350
Language: English
Additional information: This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.
Keywords: Coronary-artery calcium, intima-media thickness, physical-activity, cardiovascular-disease, risk-factors, gait variability, association, calcification, performance, disability
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Cardiovascular Science > Clinical Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: http://discovery.ucl.ac.uk/id/eprint/136813
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