Associations between cardiovascular risk factors, disease activity and cardiorespiratory fitness in patients with inflammatory joint disease: a cross-sectional analysis

Abstract

Background Inflammatory joint diseases (IJD) are accompanied by an increased risk of cardiovascular disease (CVD). Cardiorespiratory fitness (CRF) is a modifiable CVD risk factor and low levels of CRF associate with an elevated CVD risk. This study aimed to investigate the associations between CVD risk factors, disease activity and CRF in patients with IJD and to explore differences between patients with normal versus low levels of CRF. Methods CRF was measured as peak oxygen uptake (VO2peak) with a cardiopulmonary exercise test. Participants were also evaluated for: Body composition, blood pressure, blood lipids, inflammatory markers and disease activity. Patient-reported use of cigarettes/snuff, medication, disease duration, pain, fatigue, CVD history, habitual physical activity and exercise beliefs and self-efficacy were collected by questionnaire. Cross-sectional associations between CVD risk factors, disease-related factors and CRF were analyzed by multiple linear regression. CRF was categorized to normal CRF (VO2peak ≥ 80%) or low CRF (VO2peak < 80%) according to age- and gender-stratified reference data. Differences in demographic, CVD and disease-related factors between patients with normal versus low CRF were explored. Results In 60 Norwegian patients with IJD [34 females, age 59 years (IQR: 52–63)], mean VO2peak was 30.2 (± 6.9) mL/kg/min, corresponding to 83% (± 18) of normative reference values. Age (coefficient: − 0.18 years, p = 0.01) and fat mass (coefficient: − 0.67 %, p < 0.001) were inversely associated with CRF, while physical activity index (coefficient: 0.13 points, p = 0.05) was positively associated with CRF (R2 = 0.66). There were no significant associations between CRF, classical CVD risk factors and disease-related variables. Compared to patients with low CRF (n = 30), patients with normal CRF (n = 30) had higher peak oxygen uptake (+ 9.4 mL/kg/min, p < 0.001), high-density lipoprotein cholesterol (+ 0.5 mmol L−1, p < 0.001), and exercise self-efficacy (+ 6.9, p < 0.01) as well as lower fat mass (− 8.7%, p < 0.001), resting heart rate (− 8.0 beats/min, p < 0.01) and triglycerides (− 0.5 mmol L−1, p < 0.01). Conclusions In this sample of IJD-patients, age, fatmass and physical activity level were associated with CRF. CRF was lower than reference values and patients with normal CRF presented with a more favorable health profile. There is a continued need for exercise interventions to improve CRF in patients with IJD. Trial registration: NCT04922840.

Relationships between cardiopulmonary function and dangerous cardiovascular factors in Chinese adults: A cross-sectional study

“…Although a causal relationship cannot be inferred from these cross-sectional data, a better CRF may result from increased exercise, which also positively affects body composition, blood glucose, and lipid levels. Similar to this study, Nordén et al concluded that patients with in ammatory joint disease and normal CRF had better adipose, HDL-C, and TG levels than those with in ammatory joint disease and low CRF [10]. Moreover, Aspenes et al observed a favorable cardiovascular risk pro le for individuals in the high CRF quartiles, whereas individuals in the low quartiles had increased odds of clustering in CVD risk factors.…”

“…Medical background information was collected from the patient's medical records. CRF was assessed by a cardiopulmonary exercise test on a treadmill [10]. A modi ed Balke continuous ramp protocol was applied with the initial speed individualized to the patient's preference.…”

Criterion Validity and Responsiveness of Estimated Cardiorespiratory Fitness Models in Patients with Inflammatory Joint Disease

“…Additionally, IJD associates with an increased risk of CVD, influenced by systemic inflammation and a higher prevalence of classic CVD risk factors [10][11][12]. There are multiple observations of inferior levels of CRF in patients with rheumatoid arthritis [13,14], spondyloarthritis [15,16], and combined diagnoses [17], and low levels of CRF may contribute to the elevated CVD and mortality risk [18,19]. Accurate assessment of CRF is therefore of clinical value in IJD care, as it can shed light on CVD risk and measure the effects of interventions designed to enhance CRF.…”