| Title: | Walking Pace Optimizes Conventional Cardiovascular Disease Risk Prediction Models Among Vulnerable Subpopulations: A Prospective Cohort Study. |
| Journal: | Journal of the American Heart Association |
| Published: | 28 Apr 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42047187/ |
| DOI: | https://doi.org/10.1161/jaha.125.042337 |
| URL: | http://dx.doi.org/10.1161/jaha.125.042337 |
Publication 17813
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Abstract
BACKGROUND: Grip strength and walking pace are potential indicators of adverse health outcomes for the general population. However, their role in primary cardiovascular disease (CVD) prevention among various subpopulations remains uncertain.</p>
METHODS: A total of 206 371 individuals without CVD (aged 40-69 years) from the UK Biobank were included. Four conventional CVD prediction models (Framingham, Reynolds, ASSessing cardiovascular risk using Scottish Intercollegiate Guidelines Network [ASSIGN], and pooled cohort equations [PCEs]) were used to estimate 10-year CVD risk. Model performances were compared across diverse subpopulations defined by age, grip strength, or walking pace using a C index and calibration plot in the UK Biobank. Added predictive value was further validated in ELSA (English Longitudinal Study of Ageing).</p>
RESULTS: During the follow-up period 19 664 cases of incident CVD were registered (mean 12.85 years [SD 2.74]). Vulnerable subpopulations were characterized by advanced age, low grip strength, or slow walking pace. The ASSIGN model showed lower C indexes in vulnerable subpopulations: 0.659 (95% CI, 0.646-0.672) for low grip strength versus 0.702 (95% CI, 0.699-0.706) for normal grip strength, 0.646 (95% CI, 0.635-0.657) for slow walking pace versus 0.701 (95% CI, 0.698-0.705) for normal walking pace, and 0.624 (95% CI, 0.614-0.634) for older versus 0.701 (95% CI, 0.689-0.712) for young subpopulation. Adding walking pace to the ASSIGN model improved its discriminative ability in the older subpopulation with low grip strength (C index change, 0.027 [95% CI, 0.009-0.045]). The finding was similar in ELSA.</p>
CONCLUSIONS: Walking pace, but not grip strength, improved the performance of conventional CVD prediction models among vulnerable subpopulations. This highlights the role of physical function in primary prevention of CVD.</p>
6 Authors
- Li Wang
- Xueqin Li
- Xueqing Jia
- Yuyang Zheng
- Zuyun Liu
- Jing Shao
1 Application
| Application ID | Title |
|---|---|
| 61856 | The role of biological aging in the effect of genetic and environmental factors on health outcomes |
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