Exercise capacity low in AxSpA, translates to increased long-term CV risk

Patients with axial spondyloarthritis (AxSpA) appear to have markedly low exercise capacity, which contributes to heightened 10-year cardiovascular (CV) event risk in this population, a study reports.

The cross-sectional controlled study included 38 AxSpA patients and 38 matched controls. All participants underwent a maximal treadmill exercise test by Bruce protocol.

CV risk profile data were recorded, as were physical activity, 10-year CV event risk estimated by the Framingham model, and Ankylosing Spondylitis Disease Activity Score – C-reactive protein. Analyses of covariance and linear regression were performed to examine the association between exercise capacity and CV risk factors.

Compared with controls, patients had significantly lower exercise capacity (mean difference [MD] 2.2; metabolic equivalents 0.91–3.49; p=0.001). This difference persisted despite adjustments for confounders (p=0.001).

Exercise capacity correlated with age, 10-year CV event risk, body mass index (BMI), and waist circumference in both patients (p<0.001) and controls (p<0.05). Among the former, exercise capacity also had a significant association with total cholesterol (p=0.04), triglycerides (p<0.001), and heart rate recovery (HRR; p=0.006).

Furthermore, nonradiographic AxSpA patients had a markedly higher high-density lipoprotein cholesterol (p=0.026) and much lower BMI (p=0.03).

In the AxSpa group, significant predictors of exercise capacity were age and triglyceride levels (p=0.003 for both).