Estimation of maximal oxygen consumption and heart rate recovery using the Tecumseh sub-maximal step test and their relationship to cardiovascular risk factors

BACKGROUND: Maximum aerobic capacity (VO(2)max) is associated with lower cardiovascular and total mortality. Step tests can be used to provide an estimate of (VO(2)max) in epidemiological or home-based studies. We compared different methods of estimation of VO(2)max and heart rate recovery and evaluated the relationship of these estimates with cardiovascular risk factors. METHODS: Data were analysed from 2286 participants in the Tecumseh Community Health Study (>16 y and <70 y) who performed a step test. VO(2)max was estimated from heart rate using three methods and the results compared. The magnitude of heart rate recovery (HRR) and the time constant of recovery based on different time intervals post-exercise were also estimated. RESULTS: Estimated VO(2)max showed good or poor agreement depending on the method used. VO(2)max correlated inversely with systolic blood pressure (SBP), body mass index (BMI), total cholesterol, blood glucose following a 100 g oral load (PLG) and Framingham risk score. In a multivariable model age sex, cigarette smoking, SBP, BMI and PLG were significantly inversely associated with VO(2)max. Correlations with risk factors were strongest for HRR measured over the first 30 s of recovery. Only the time constant calculated from the 3 min post-exercise period correlated significantly with risk factors. CONCLUSIONS: The Tecumseh step test can be used to provide estimates of VO(2)max and heart rate recovery. Estimated VO(2)max was inversely associated with higher systolic BP, higher BMI and worse glucose tolerance. Measurements of HRR over the first 30 s and the time constant calculate from the first 3 min of recovery correlate most closely with risk factors.