Exercise cardiac power and the risk of coronary heart disease and cardiovascular mortality in men.
The aim of this study was to examine the relationship of exercise cardiac power (ECP), defined as a ratio of directly measured maximal oxygen uptake with peak systolic blood pressure during exercise, with the risk of mortality from coronary heart diseases (CHD) and cardiovascular diseases (CVD).



Population-based cohort study with an average follow-up of 25 years from eastern Finland. About 2358 men at baseline participated in exercise stress test and 182 CHD and 302 CVD deaths occurred.



Men with low ECP (< 8.7 mL/mmHg, lowest quartile) had a 3.5-fold (95% CI 2.1-5.8, p < 0.0001) risk of CHD mortality as compared with men with high ECP (>16.4 mL/mmHg, highest quartile) after adjusting for age and examination year. Low ECP was associated with a 2.8-fold risk of CHD and 2.4-fold for CVD mortality after additional adjustment for conventional risk factors. After further adjustment for leisure time physical activity, the results hardly changed (HR 2.5, 95% CI 1.71-3.67, p < 0.001).



ECP provides non-invasive and easily available measure for the prediction of CHD and CVD mortality. One of the most potential explanation for the association between ECP and the risk of CHD and CVD mortality is an elevated afterload and peripheral resistance indicated by hypertension. Key messages Index of exercise cardiac power defined as the ratio of directly measured maximal oxygen uptake (VO2max) with peak systolic blood pressure gives prognostic information in coronary heart disease (CHD) and CVD mortality risk stratification. ECP provides non-invasive and easily available measure for the prediction of CHD and CVD mortality. One of the most potential explanation for the association between ECP and the risk of CHD and CVD mortality is an elevated afterload and peripheral resistance indicated by hypertension.
a Institute of Public Health and Clinical Nutrition , University of Eastern Finland , Kuopio , Finland.
Sudhir
S
Kurl
b Division of Cardiology, Department of Internal Medicine , University Hospital of Oulu , Oulu , Finland.
Timo
T
Mäkikallio
c Department of Sports Informatics, College of Arts and Physical Education , University of Seoul , South Korea.
Sae Young
SY
Jae
a Institute of Public Health and Clinical Nutrition , University of Eastern Finland , Kuopio , Finland.
Kimmo
K
Ronkainen
a Institute of Public Health and Clinical Nutrition , University of Eastern Finland , Kuopio , Finland.|d Central Finland Hospital , Jyväskylä , Finland.
Jari A
JA
Laukkanen
D000328:Adult; D002318:Cardiovascular Diseases / Q000401:mortality*; D015331:Cohort Studies; D003327:Coronary Disease / Q000401:mortality*; D005080:Exercise Test; D017079:Exercise Tolerance; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis
Coronary heart disease mortality; exercise cardiac power; men