Usefulness of physical fitness and the metabolic syndrome to predict vascular disease risk in older Chinese (from the Guangzhou Biobank Cohort Study-Cardiovascular Disease Subcohort [GBCS-CVD])

Association between cardiorespiratory, muscular fitness and metabolic syndrome in Korean men

AIMS

Cardiorespiratory and muscular fitness (CRF, MF) are independent predictor of metabolic syndrome (MS). The purpose of this study was to investigate the association between CRF, MF and MS in male adults.

METHODS

Data collected from 10,774 males who visited the National Fitness Center between 2002 and 2009. The data included measurements of subjects' blood pressure, HDL-cholesterol, triglycerides, body mass index, CRF (VO₂max), MF (grip strength, push-up, sit-up, knee joint strength). CRF, MF level was classified into three tertiles.

RESULTS

As for the prevalence rate according to CRF level, the differences between groups were 47.6% of the low CRF group, 33.1% of the middle CRF group, and 19.3% of the high CRF group were found to have MS. As for the MS prevalence rate according to MF level, the differences between groups were 47.1% of the low, 31.8% of the middle, 21.1% of the high MF group were found to MS. It was found that MS odds ratios (OR, 95% confidence interval) decreased as the CRF levels improved; as indicated by OR = 0.64 (0.57-0.72) in the middle CRF, OR = 0.36 (0.31-0.41) in the high CRF. As for MF, the middle MF, OR = 0.62 (0.55-0.70), the high MF, OR = 0.40 (0.35-0.45) were lower than that of the low MF.

CONCLUSION

The level of CRF, MF has association with MS in men. This study suggests that we need to manage our fitness to prevent MS.

Effect of handgrip on coronary artery disease and myocardial infarction: a Mendelian randomization study

Observational studies have reported an association of handgrip strength with risk of cardiovascular disease. However, residual confounding and reverse causation may have influenced these findings. A Mendelian randomization (MR) study was conducted to examine whether handgrip is causally associated with cardiovascular disease. Two single nucleotide polymorphisms (SNPs), rs3121278 and rs752045, were used as the genetic instruments for handgrip. The effect of each SNP on coronary artery disease/myocardial infarction (CAD/MI) was weighted by its effect on handgrip strength, and estimates were pooled to provide a summary measure for the effect of increased handgrip on risk of CAD/MI. MR analysis showed that higher grip strength reduces risk for CAD/MI, with 1-kilogram increase in genetically determined handgrip reduced odds of CAD by 6% (odds ratio (OR) = 0.94, 95% confidence interval (CI) 0.91–0.99, P = 0.01), and reduced odds of MI by 7% (OR = 0.93, 95% CI 0.89–0.98, P = 0.003). No association of grip strength with type 2 diabetes, body mass index, LDL- and HDL-cholesterol, triglycerides and fasting glucose was found. The inverse causal relationship between handgrip and the risk of CAD or MI suggests that promoting physical activity and resistance training to improve muscle strength may be important for cardiovascular health.

Influence of heart rate at rest for predicting the metabolic syndrome in older Chinese adults

The aim of this study was to examine the relationship between seated resting heart rate and the metabolic syndrome (MetS) among older residents of Guangzhou, South China. A total of 30,519 older participants (≥50 years) from the Guangzhou Biobank Cohort Study were stratified into quartiles based on seated resting heart rate. The associations between each quartile and the MetS were assessed using multivariable logistic regression. A total of 6,907 (22.8 %) individuals were diagnosed as having the MetS, which was significantly associated with increasing heart rate quartiles (P < 0.001). Participants in the uppermost quartile (mean resting heart rate 91 ± 8 beats/min) of this cardiovascular proxy had an almost twofold increased adjusted risk (odds ratio (95 % CI) = 1.94 (1.79, 2.11), P < 0.001) for the MetS, as compared to those in the lowest quartile (mean resting heart rate, 63 ± 4 beats/min). Heart rate, which is an inexpensive and simple clinical measure, was independently associated with the MetS in older Chinese adults. We hope these observations will spur further studies to examine the usefulness of resting heart rate as a means of risk stratification in such populations, for which targeted interventions should be implemented.

Treatment patterns and risk factor control in patients with and without metabolic syndrome in cardiac rehabilitation

Aim

Metabolic syndrome (MetS) is a clustering of factors that are associated with increased cardiovascular risk. We aimed to investigate the proportion of patients with MetS in patients undergoing cardiac rehabilitation (CR), and to describe differences between patients with MetS compared to those without MetS with regard to (1) patient characteristics including demographics, risk factors, and comorbidities, (2) risk factor management including drug treatment, and (3) control status of risk factors at entry to CR and discharge from CR.

Methods

Post-hoc analysis of data from 27,904 inpatients (Transparency Registry to Objectify Guideline-Oriented Risk Factor Management registry) that underwent a CR period of about 3 weeks were analyzed descriptively in total and compared by their MetS status.

Results

In the total cohort, mean age was 64.3 years, (71.7% male), with no major differences between groups. Patients had been referred after a ST elevation of myocardial infarction event in 41.1% of cases, non-ST elevation of myocardial infarction in 21.8%, or angina pectoris in 16.7%. They had received a percutaneous coronary intervention in 55.1% and bypass surgery (coronary artery bypass graft) in 39.5%. Patients with MetS (n = 15,819) compared to those without MetS (n = 12,085) were less frequently males, and in terms of cardiac interventions, more often received coronary artery bypass surgery. Overall, statin use increased from 79.9% at entry to 95.0% at discharge (MetS: 79.7% to 95.2%). Patients with MetS compared to those without MetS received angiotensin converting enzyme inhibitors, angiotensin receptor blockers, oral antidiabetics, and insulin at entry and discharge more frequently, and less frequently clopidogrel and aspirin/clopidogrel combinations. Mean blood pressure was within the normal range at discharge, and did not differ substantially between groups (124/73 versus 120/72 mmHg). Overall, between entry and discharge, levels of total cholesterol, low density lipoprotein cholesterol, and triglycerides were substantially lowered, in particular in MetS patients. Thus, control rates of lipid parameters improved substantially, with the exception of high density lipoprotein cholesterol. Low density lipoprotein cholesterol rates <100 mg/dL increased from 38.7% at entry to 73.8% at discharge (MetS: from 39.4% to 74.6%) and triglycerides control rates (<150 mg/dL) from 58.1% to 70.4% (MetS: 43.7% to 62.2%). Physical fitness on exercise testing improved substantially in both groups.

Conclusion

Patients with and without MetS benefited substantially from the participation in CR, as their lipid profile, blood pressure, and physical fitness improved. Treatment effects were similar in the two groups.