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Prediction of Cardiorespiratory Fitness in Older Men Infected with the Human Immunodeficiency Virus: Clinical Factors and Value of the Six‐Minute Walk Distance
Author(s) -
Oursler Krisann K.,
Katzel Leslie I.,
Smith Barbara A.,
Scott Wayne B.,
Russ David W.,
Sorkin John D.
Publication year - 2009
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2009.02495.x
Subject(s) - medicine , cardiorespiratory fitness , physical therapy , isometric exercise , veterans affairs , population , comorbidity , grip strength , hand strength , cohort , cross sectional study , vo2 max , viral load , cardiology , human immunodeficiency virus (hiv) , heart rate , blood pressure , immunology , pathology , environmental health
OBJECTIVES: To investigate factors related to cardiorespiratory fitness in older human immunodeficiency virus (HIV)‐infected patients and to explore the utility of 6‐minute walk distance (6‐MWD) in measuring fitness. DESIGN: Cross‐sectional study in clinic‐based cohort. SETTING: Veterans Affairs Medical Center, Baltimore, Maryland. PARTICIPANTS: Forty‐three HIV‐infected men, median age 57 (range 50–82), without recent acquired immunodeficiency syndrome–related illness and receiving antiretroviral (ARV) therapy. MEASUREMENTS: Peak oxygen utilization (VO 2 peak) according to treadmill graded exercise testing, 6‐MWD, grip strength, quadriceps maximum voluntary isometric contraction, cross‐sectional area, muscle quality, and muscle adiposity. RESULTS: There was a moderate correlation between VO 2 peak (mean ± SD; 18.4 ± 5.6 mL/kg per minute) and 6‐MWD (514 ± 91 m) ( r =0.60, P <.001). VO 2 peak was lower in subjects with hypertension (16%, P <.01) and moderate anemia (hemoglobin 10–13 gm/dL; 15%, P =.09) than in subjects without these conditions. CD4 cell count (median 356 cells/mL, range 20–1,401) and HIV‐1 viral load (84% nondetectable) were not related to VO 2 peak. Among muscle parameters, only grip strength was an independent predictor of VO 2 peak. Estimation of VO 2 peak using linear regression, including age, 6‐MWD, grip strength, and hypertension as independent variables, explained 61% of the variance in VO 2 peak. CONCLUSION: Non‐AIDS‐related comorbidity predicts cardiorespiratory fitness in older HIV‐infected men receiving ARV therapy. The 6‐MWD is a valuable measure of fitness in this patient population, but a larger study with diverse subjects is needed.