Good cardiorespiratory fitness (high VO2max) has beneficial effects on morbidity and mortality. Therefore, a tool to estimate VO2max in daily clinical practice is of great value for preventing chronic diseases in healthy adults. This study aimed at exploring the cardiometabolic profile in a representative Swiss working population. Based on these insights, a regression model was derived revealing factors associated with VO2max.Cross-sectional data of 337 healthy and full-time employed adults recruited in the Basel region, Switzerland, were collected. Anthropometric measurements to compute body mass index (BMI) and waist circumference (WC) were performed. A 20-meter shuttle run test was conducted to determine individual VO2max. Heart rate (HR) was measured at rest, during maximal exertion, and two minutes after exercise. Systolic (SBP) and diastolic blood pressure (DBP) were assessed at rest and after exercise. A multiple linear regression model was built to identify a set of nonexercise predictor variables of VO2max.Complete data of 303 individuals (63% male) aged 18 to 61 years (mean 33 ± 12 years) were considered for analysis. The regression model (adjusted R2 = 0.647, SE = 5.3) identified sex (β = -0.699, p < 0.001), WC (β = -0.403, p < 0.001), difference of maximal to resting HR (β = 0.234, p < 0.001), smoking (β = -0.171, p < 0.001), and age (β = -0.131, p < 0.01) as the most important factors associated with VO2max, while BMI, SBP, and DBP did not contribute to the regression model.This study introduced a simple model to evaluate VO2max based on nonexercise parameters as part of daily clinical routine without needing a time-consuming, cost-intense, and physically demanding direct assessment of VO2max. Knowledge about VO2max may help identifying individuals at increased cardiovascular risk and may provide the basis for health counselling and tailoring preventive measures.
Objective: Data on the metabolic profile and predictors of physical fitness are urgently needed to individually tailor preventive measures in Western European working populations. This study aimed to explore parameters reflecting health status as well as metabolic parameters in a representative Swiss working population. An integrative model shall be derived revealing predictors of maximal aerobic capacity (VO2max). Design and method: The study draws on cross-sectional data of 337 healthy and at least 80% employed individuals recruited in Switzerland. A questionnaire gathered personal and job-related parameters. Anthropometric data to compute Body Mass Index (BMI) and waist circumference (WC) were collected. Heart rate (HR) at rest, during maximal exertion, and two minutes after exercise were measured. Systolic (SBP) and diastolic blood pressure (DBP) was assessed at rest and after exercise. A multistage 20 m shuttle run test was conducted to determine individual VO2max. Differences between three fitness level groups based on VO2max were assessed. A multi-linear regression model was developed to identify a set of non-exercise predictor variables of VO2max. Results: Complete data of 303 individuals aged 18 to 61 years were included into the analysis. Individuals in the highest fitness category were younger (p < 0.001), had a lower BMI (p < 0.001) as well as a higher differential maximal to resting HR (p < 0.001), and were physically more active (higher daily moderate to vigorous physical activity, p < 0.05; and more steps per day, p < 0.01). The double product (HR x SBP) in this group was significantly lower (p < 0.05). Regression analysis (adjusted R2 = 0.647) revealed significant influence of female gender (B = −0.699, p < 0.001), WC (B = −0.403, p < 0.001), differential maximal to resting HR (B = 0.234, p < 0.001), smoking (B = −0.171, p < 0.001), and age (B = −0.131, p < 0.01) on VO2max as dependent variable. Conclusions: Our study presents a model for accurately predicting VO2max based on non-exercise parameters without direct assessment of VO2max. These results provide the basis for a novel approach to evaluate VO2max to individually tailor exercise programs for the prevention of cardiovascular disease.
Mobility limitations in older adults are associated with poor clinical outcomes including higher mortality and disability rates. A decline in mobility (including physical function and life-space) is detectable and should be discovered as early as possible, as it can still be stabilized or even reversed in early stages by targeted interventions. General practitioners (GPs) would be in the ideal position to monitor the mobility of their older patients. However, easy-to-use and valid instruments for GPs to conduct mobility assessment in the real-life practice setting are missing. Modern technologies such as the global positioning system (GPS) and inertial measurement units (IMUs) - nowadays embedded in every smartphone - could facilitate monitoring of different aspects of mobility in the GP's practice.This project's aim is to provide GPs with a novel smartphone application that allows them to quantify their older patients' mobility. The project consists of three parts: development of the GPS- and IMU-based application, evaluation of its validity and reliability (Study 1), and evaluation of its applicability and acceptance (Study 2). In Study 1, participants (target N = 72, aged 65+, ≥2 chronic diseases) will perform a battery of walking tests (varying distances; varying levels of standardization). Besides videotaping and timing (gold standard), a high-end GPS device, a medium-accuracy GPS/IMU logger and three different smartphone models will be used to determine mobility parameters such as gait speed. Furthermore, participants will wear the medium-accuracy GPS/IMU logger and a smartphone for a week to determine their life-space mobility. Participants will be re-assessed after 1 week. In Study 2, participants (target N = 60, aged 65+, ≥2 chronic diseases) will be instructed on how to use the application by themselves. Participants will perform mobility assessments independently at their own homes. Aggregated test results will also be presented to GPs. Acceptance of the application will be assessed among patients and GPs. The application will then be finalized and publicly released.If successful, the MOBITEC-GP application will offer health care providers the opportunity to follow their patients' mobility over time and to recognize impending needs (e.g. for targeted exercise) within pre-clinical stages of decline.
Purpose: The objective of this study was to analyze the association of functional aerobic capacity (VO2max) with work and non-work related physical activity as measured by the SenseWear Mini armband in a Swiss working population.
Methods: In this cross-sectional study, a total of 337 healthy and at least 80% employed adult workers were recruited. Demographic data, height, weight and body mass index (BMI) were recorded in all subjects. Energy expenditure and physical activity were measured by the SenseWear Mini armband for seven consecutive days (23 hours/day). VO2max was evaluated using the multistage 20 meter shuttle run test.
Results: 303 participants were considered for analysis (63% male, 37% female, age 33.3 yrs, SD 12.4, BMI 24.3 kg/m2, SD 3.4). Multiple linear regression analysis (R2 = 0.70) with VO2max as dependent variable showed significant positive associations of VO2max with leisure-time physical activity (LTPA) at high intensity (β = 0.111) and with active energy expenditure (β = 0.122), but not with occupational physical activity (OPA) at any intensity. Gender (β = -0.599), age (β = -0.271), BMI (β = -0.265), smoking (β = -0.132) and the ratio of maximum to resting heart rate (β = 0.183) were also identified as independent predictors of VO2max. On workdays, VO2max was significantly higher in participants who fulfilled the global recommendations on physical activity compared to insufficiently active counterparts.
Conclusion: The present results suggest that VO2max was positively associated with LTPA, but not with OPA on workdays. This finding emphasizes the need for employees to engage in sufficient high-intensity physical activity in recreation for maintaining or improving VO2max with regard to health benefits.
Key Words: MAXIMUM OXYGEN UPTAKE, OCCUPATIONAL PHYSICAL ACTIVITY, LEISURE-TIME PHYSICAL ACTIVITY, SENSEWEAR MINI ARMBAND, INTERNATIONAL PHYSICAL ACTIVITY QUESTIONNAIRE (IPAQ)
This study aimed to determine physical performance criteria of different occupational groups by investigating physical activity and energy expenditure in healthy Swiss employees in real-life workplaces on workdays and non-working days in relation to their aerobic capacity (VO2max). In this cross-sectional study, 337 healthy and full-time employed adults were recruited. Participants were classified (nine categories) according to the International Standard Classification of Occupations 1988 and merged into three groups with low-, moderate- and high-intensity occupational activity. Daily steps, energy expenditure, metabolic equivalents and activity at different intensities were measured using the SenseWear Mini armband on seven consecutive days (23 hours/day). VO2max was determined by the 20-meter shuttle run test. Data of 303 subjects were considered for analysis (63% male, mean age: 33 yrs, SD 12), 101 from the low-, 102 from the moderate- and 100 from the high-intensity group. At work, the high-intensity group showed higher energy expenditure, metabolic equivalents, steps and activity at all intensities than the other groups (p<0.001). There were no significant differences in physical activity between the occupational groups on non-working days. VO2max did not differ across groups when stratified for gender. The upper workload limit was 21%, 29% and 44% of VO2max in the low-, moderate- and high-intensity group, respectively. Men had a lower limit than women due to their higher VO2max (26% vs. 37%), when all groups were combined. While this study did confirm that the average workload limit is one third of VO2max, it showed that the average is misrepresenting the actual physical work demands of specific occupational groups, and that it does not account for gender-related differences in relative workload. Therefore, clinical practice needs to consider these differences with regard to a safe return to work, particularly for the high-intensity group.
Objective: This study aimed to examine the association of maximal aerobic capacity (VO2max) with blood pressure (BP), heart rate (HR), body mass index (BMI) and waist circumference (WC) in a representative sample of healthy Swiss employees. Design and method: In this cross-sectional study, 337 healthy and at least 80% employed adult workers were recruited in the Basel region, Switzerland. Gender, age and smoking status (yes, no more, never) were recorded. Height, weight and WC were measured and BMI was calculated. VO2max was determined using the multistage 20-meter shuttle run test. Subjects were categorized according to the 25th (P25) and 75th percentile (P75) of VO2max. HR, systolic and diastolic BP were assessed at rest prior to testing and at test termination (maximal HR) respectively two minutes after the end of the test. Group differences between P25 and P75 were analysed with Student-t test or Mann-Whitney test. Forced-entry multiple linear regression analysis was performed to identify predictors of VO2max. Results: Complete data were available from 303 subjects aged 18 to 61 years. Descriptive statistics for total subjects, P25 and P75 are presented in Table 1. Compared to P25, subjects in P75 were mostly male, younger, had lower BMI and WC, higher resting and recovery systolic BP, lower resting but higher maximal HR and a greater difference between maximal and resting as well as recovery HR. Multiple linear regressions (Table 2) revealed that a higher VO2max was associated with a greater difference between maximal and resting HR, whereas female gender, increasing age, higher WC and current smoking contributed to a decrease of VO2max. BMI, ex-smoking, differences in BP and maximal-to-recovery HR were not related to VO2max.Conclusions: This study provides evidence that diastolic BP is not affected by aerobic exercise, while systolic BP was increased in the fittest category. The present findings suggest that maximal aerobic capacity is associated with maximal and resting HR, but not with recovery HR. WC, but not BMI, should be preferably used to assess the association between aerobic capacity and body composition.
Aims Few data are available on cardiovascular risk stratification in primary care patients treated for arterial hypertension. This study aimed at evaluating the cardiovascular risk profile of hypertensive patients included into the Swiss Hypertension Cohort Study according to the 2013 European Society of Hypertension/European Society of Cardiology Guidelines. Methods The Swiss Hypertension Cohort Study is a prospective, observational study conducted by the Centre for Primary Health Care of the University of Basel from 2006 to 2013. Patients with a diagnosis of arterial hypertension (office blood pressure measurement ≥140/90 mmHg) were enrolled. Office blood pressure measurement, cardiovascular risk factors, subclinical organ damage, diabetes mellitus, and established cardiovascular and renal disease were recorded at baseline and at an annual interval during routine consultations by general practitioners in Switzerland. Results In total, 1003 patients were eligible for analysis (55.6% male, mean age: 64.0 ± 13.2 years). At baseline, 78.5% of patients presented with either more than three additional cardiovascular risk factors, diabetes mellitus or subclinical organ damage, while 44.4% of patients had a high or very high overall cardiovascular risk. Cardiovascular risk factors and information about diabetes mellitus, established cardiovascular disease and renal disease were recorded mostly completely, whereas substantial gaps were revealed regarding the assessment of subclinical organ damage. Conclusion The present findings demonstrate that the majority of primary care patients with arterial hypertension bear a substantial number of additional cardiovascular risk factors, subclinical and/or established organ damage. This emphasizes the need for continuous cardiovascular risk stratification and adequate treatment of arterial hypertension in Switzerland.
Objective: Heart failure (HF) with preserved ejection fraction (HFpEF) occurs in about 50% of all HF patients. Remodeling and fibrosis stimulated by inflammation appear to be main factors for the progression of HFpEF. Furthermore, iron deficiency (ID) has been recognized to be a common comorbidity in HFpEF. The lack of prognostic treatment options in HFpEF urgently calls for new therapeutic approaches. While beneficial effects of exercise training and iron substitution have been demonstrated in HF with reduced ejection fraction, they have not yet been evaluated in HFpEF. Therefore, the aim of this study is to investigate the effect of exercise training in HFpEF patients with optimally adjusted iron values. Exercise tolerance will be the primary outcome. Design and method: The proposed study will be a prospective, single-blind, randomized controlled trial in a primary care setting including 98 patients with stable HFpEF. Patients will undergo 3 study visits including measurements of disease-specific biomarkers, cardiac and arterial vessel structure and function, exercise tolerance, habitual physical activity, and quality of life (QoL). After the first visit, patients with ID will undergo iron substitution until sufficient iron levels are reached (over max. 12 weeks), in order to ensure comparable baseline conditions for the training intervention. The study measurements will be repeated after 12 weeks in both, initially iron deficient and non-iron deficient patients. Patients will then be randomized to the intervention or control group, stratified by initial iron-deficiency status. The intervention group (n = 49) will attend a supervised 12-week high-intensity interval training on a bicycle ergometer. The control group (n = 49) will continue to undergo usual care. After 12 weeks, the study measurements will be repeated in all patients to monitor the effects of the intervention. At 6 months, 1, 2, and 3 years after the last visit, telephone interviews will be performed to assess medical outcomes and QoL. Results: As it is a protocol proposal, there are no results yet. Conclusions: This study is expected to add important knowledge about the potential utility of a novel treatment strategy in HFpEF patients, which may help to improve both, QoL and functional status.
Objective data on the association of maximal aerobic capacity (VO2max) with work related physical activity are sparse. Thus, it is not clear whether occupational physical activity (OPA) contributes to an increase of VO2max. This study examined the association of VO2max with work and non-work related physical activity in a Swiss working population.In this cross-sectional study, a total of 337 healthy and full-time employed adults were recruited. Demographic data, height, weight and BMI were recorded in all subjects. Participants were classified into nine occupational categories (ISCO-88) and merged into three groups with low, moderate, and high OPA. Physical activity was objectively measured by the SenseWear Mini Armband on seven consecutive days (23 hours per day). Participants were regarded as sufficiently active when accumulating ≥30 min of moderate-to-vigorous physical activity per day. VO2max was evaluated using the multistage 20-meter shuttle run test.Data of 303 participants were considered for analysis (63% male, age 33 yrs, SD 12). Multiple linear regression analysis (adjusted R2 = 0.69) revealed significant positive associations of VO2max with leisure-time physical activity (LTPA) at vigorous intensity (β = 0.212) and sufficient moderate-to-vigorous physical activity (β = 0.100) on workdays. Female gender (β = -0.622), age (β = -0.264), BMI (β = -0.220), the ratio of maximum to resting heart rate (β = 0.192), occupational group (low vs. high OPA, β = -0.141), and smoking (β = -0.133) were also identified as independent predictors of VO2max.The present results suggest that VO2max is positively associated with LTPA, but not with OPA on workdays. This finding emphasizes the need for employees to engage in sufficient high-intensity physical activity in recreation for maintaining or improving VO2max with regard to health benefits.
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