Impact of Improvement in Walking Speed on Hospitalization and Mortality in Females with Cardiovascular Disease

Cardiovascular disease (CVD) is the principal cause of death in women. Walking speed (WS) is strongly related with mortality and CVD. The rate of all-cause hospitalization or death was assessed in 290 female outpatients with CVD after participation in a cardiac rehabilitation/secondary prevention program (CR/SP) and associated with the WS maintained during a moderate 1 km treadmill-walk. Three-year mortality rates were 57%, 44%, and 29% for the slow (2.1 +/- 0.4 km/h), moderate (3.1 +/- 0.3 km/h), and fast (4.3 +/- 0.6 km/h) walkers, respectively, with adjusted hazard ratios (HRs) of 0.78 (p =0.24) and 0.55 (p =0.03) for moderate and fast walkers compared to the slow walkers. In addition, hospitalization or death was examined four to six years after enrollment as a function of the change in the WS of 176 patients re-assessed during the third year after baseline. The rates of hospitalization or death were higher across tertiles of reduced WS, with 35%, 50%, and 53% for the high (1.5 +/- 0.3 km/h), intermediate (0.7 +/- 0.2 km/h), and low tertiles (0.2 +/- 0.2 km/h). Adjusted HRs were 0.79 (p =0.38) for the intermediate and 0.47 (p =0.02) for the high tertile compared to the low improvement tertile. Improved walking speed was associated with a graded decrease in hospitalization or death from any cause in women undergoing CR/SP.