Abstract P2133: Physical performance and coronary heart disease, cardiovascular disease and all-cause mortality: the REasons for Geographic And Racial Differences in Stroke prospective cohort study

Background: Poor physical performance, often measured by gait speed and chair stand tests, has been linked to mortality, but patterns may differ depending on prior history of cardiovascular disease (CVD). Objective: To examine associations between physical performance and death from coronary heart disease (CHD), CVD, and all-cause by history of CVD. Methods: Among 14,137 REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants (2013-2016), participants were categorized by quartiles of gait speed and chair stand times or inability to complete the test. Deaths (CHD, CVD, and all-cause) were adjudicated through December 31, 2020. Stratified by history of CVD, we created survival curves and conducted Cox proportional hazards models adjusted for demographics, health behaviors, and medical history. Results: The average age of participants was 72.54±8.5, 56.1% were female, 63.3% were White, 36.7% were Black, and 42.9% had history of CVD; 2,749 participants died. Compared to the fastest quartile, participants with history of CVD and slowest gait speeds had adjusted hazards ratios (HRs) of 1.29 (95% CI: 0.75, 2.23) for CHD, 1.37 (0.92, 2.05) for CVD, and 1.81 (1.47, 2.23) for all-cause mortality; HR for those with incomplete gait speed tests were 1.66 (0.80, 3.44), 3.07 (1.94, 4.86), and 3.19 (2.48, 4.10), respectively. Participants with history of CVD and the slowest quartile of chair stand time had HRs of 1.05 (95% CI: 0.62, 1.78) for CHD, 1.49 (1.08, 2.04) for CVD, and 1.82 (1.48, 2.23) for all-cause mortality; those with incomplete chair stand tests had HR of 1.33 (0.76, 2.33), 2.30 (1.68, 3.16), and 3.18 (2.47, 4.09), respectively. A similar pattern was seen among those without history of CVD, but the magnitude of the associations was lower (p-interaction = 0.345, 0.028, and 0.026 for CHD, CVD, and all-cause mortality, respectively, for gait speed tests and p-interaction = 0.064, 0.084, and 0.034 for CHD, CVD, and all-cause mortality, respectively, for chair stand tests). Conclusions: While physical performance was associated with mortality among individuals with and without CVD, poor physical performance may be a stronger marker for risk of death among those with CVD.