Poor Physical Function an Independent Predictor for Cardiovascular Disease Outcomes

Patients with cardiovascular disease should be monitored for decreased physical function, as it can be a predictor of clinical outcomes.

Cardiovascular disease (CVD) outcomes can be independently predicted via reduced physical function among adults. These findings were published in Journal of the American Heart Association.

Investigators from the Johns Hopkins Bloomberg School of Public Health in the United States (US) sourced data for this study from the Atherosclerosis Risk in Communities (ARIC) study, which was a community-based, prospective cohort study. Individuals (N=15,792) aged 45 to 64 years in 4 communities in the US were enrolled between 1987 and 1989. For this analysis, visit 5 (2011-2013) of the ARIC study (n=5570) was used as baseline and risk for CVD events through visit 7 (2018-2019) was evaluated on the basis of physical function defined using the Short Physical Performance Battery (SPPB).

The study population comprised 57.7% women, had a mean age of 75.4 (standard deviation [SD], 5.1) years, 21.6% were Black patients, BMI was 28.7 (SD, 5.6), and 23.1% of patients had a history of CVD. The participants had low (n=705), intermediate (n=1671), and high (n=3194) physical functioning. Older individuals, Black individuals, and women had lower SPPB.

The 5-year cumulative incidence of CVD outcomes was 23.4% for the low, 15.3% for the intermediate, and 8.6% for the high SBBP groups.

Physical function, measured by SPPB, was independently associated with composite and individual CVD outcomes.

In the fully adjusted model, for every 1-point lower SPPB score, risk for composite CVD events (adjusted hazard ratio [aHR], 1.07; 95% CI, 1.04-1.10), coronary heart disease (CHD; aHR, 1.07; 95% CI, 1.03-1.12), stroke (aHR, 1.10; 95% CI, 1.05-1.16), and heart failure (aHR, 1.06; 95% CI, 1.02-1.10) was significantly increased.

Adding SPPB scores to traditional CVD predictors improved prediction for composite CVD events, CHD, stroke, and heart failure among all participants (DC range, 0.017-0.020) and those without a history of CVD (DC range, 0.015-0.021) and for composite CVD events, CHD, and heart failure among those with a CVD history (DC range, 0.016-0.019).

This study is unable to rule out reverse causation, in which physical function is poorer due to CVD.

“Physical function, measured by SPPB, was independently associated with composite and individual CVD outcomes,” the study authors wrote. “Our results suggest the potential usefulness of SPPB for classifying CVD risk in older adults.”

Disclosure: One of the study authors have declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 


Hu X, Mok Y, Ding N, et al. Physical function and subsequent risk of cardiovascular events in older adults: the Atherosclerosis Risk in Communities study. J Am Heart Assoc. Published online August 31, 2022. doi:10.1161/JAHA.121.025780