Functional capacity and cardiovascular risk burden: a cross-sectional analysis of the six-minute walk test in an at-risk population from 47 primary health centers in Makassar City, Indonesia
6 affiliations
- 1Makassar Cardiac Center (Pusat Jantung Terpadu), DR. Wahidin Sudirohusodo Hospital, Makassar, 90245 Indonesia
- 2Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Hasanuddin, Makassar, 90245 Indonesia
- 3Department of Physiology, Faculty of Medicine, Universitas Hasanuddin, Makassar, 90245 Indonesia
- 4Faculty of Medicine, Universitas Hasanuddin, Makassar, 90245 Indonesia
- 5Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Hasanuddin, Makassar, 90245 Indonesia
- 6Department of Public Health and Community Medicine, Faculty of Medicine, Universitas Hasanuddin, Makassar, 90245 Indonesia
Abstract
Background: Cardiovascular disease (CVD) is a major global health concern and a leading cause of death in Indonesia. This study aimed to assess how cumulative cardiovascular risk factors affect functional capacity, using the six-minute walk test (6MWT) and estimated maximal oxygen consumption (VO2max) in a high-risk population at primary care centers.
Methods: A cross-sectional study was conducted at 47 primary health centers in Makassar, Indonesia, from June to December 2021. We enrolled individuals with one or more cardiovascular risk factors. Functional capacity was evaluated using the 6MWT, and VO2max was estimated with validated equations. Risk factors, including hypertension, diabetes, dyslipidemia, smoking, obesity, family history of CVD, physically inactivity, and poor diet, were collected from medical records, patient interviews, and examinations. Statistical analyses explored the relationship between the number of risk factors and both 6MWT performance and VO2max.
Results: Among 679 participants, the mean age was 52.3 ± 10.2 years, with 80.1% being female. Hypertension, obesity, and smoking were the most prevalent risk factors. Over half (58.6%) had 4–6 risk factors. The average 6MWT distance was 379.0 ± 97.5 m, below the healthy range, and the average VO2max was 15.6 ± 5.3 ml/kg/min, indicating poor functional capacity in majority of the participants. Traditional risk factors, including sex, age, hypertension, diabetes, dyslipidemia, and physically inactivityhad a significant impact on 6MWT distance and estimated VO2max (p < 0.05). A strong positive correlation was found between VO2max and 6MWT distance (r = 0.90, 95%CI 0.88–0.91, p < 0.001), while a significant inverse relationship was noted between the number of cardiovascular risk factors and VO2max, with those having more than 6 risk factors showing significantly lower VO2max (p = 0.008).
Conclusions: This study underscores the substantial impact of cardiovascular risk factors on functional capacity and aerobic fitness. The inverse relationship between the number of risk factors and VO2max highlights the critical need for early identification and proactive management to improve functional capacity and long-term health outcomes in at-risk populations.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12875-026-03515-y.
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BibTeX
@article{mappangara2026functional,
title = {{Functional capacity and cardiovascular risk burden: a cross-sectional analysis of the six-minute walk test in an at-risk population from 47 primary health centers in Makassar City, Indonesia}},
author = {Idar Mappangara and Andriany Qanitha and Martin Perdhana Muchlis and Zaenab Djafar and Nabilah Puteri Larassaphira and Melda Warliani and Firdaus Kasim and Peter Kabo and Muzakkir Amir},
journal = {BMC Primary Care},
year = {2026},
month = aug,
doi = {10.1186/s12875-026-03515-y},
url = {https://doi.org/10.1186/s12875-026-03515-y},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Functional capacity and cardiovascular risk burden: a cross-sectional analysis of the six-minute walk test in an at-risk population from 47 primary health centers in Makassar City, Indonesia
AU - Idar Mappangara
AU - Andriany Qanitha
AU - Martin Perdhana Muchlis
AU - Zaenab Djafar
AU - Nabilah Puteri Larassaphira
AU - Melda Warliani
AU - Firdaus Kasim
AU - Peter Kabo
AU - Muzakkir Amir
PY - 2026
DA - 2026/08/10
JO - BMC Primary Care
DO - 10.1186/s12875-026-03515-y
UR - https://doi.org/10.1186/s12875-026-03515-y
AB - Background: Cardiovascular disease (CVD) is a major global health concern and a leading cause of death in Indonesia. This study aimed to assess how cumulative cardiovascular risk factors affect functional capacity, using the six-minute walk test (6MWT) and estimated maximal oxygen consumption (VO2max) in a high-risk population at primary care centers. Methods: A cross-sectional study was conducted at 47 primary health centers in Makassar, Indonesia, from June to December 2021. We enrolled individuals with one or more cardiovascular risk factors. Functional capacity was evaluated using the 6MWT, and VO2max was estimated with validated equations. Risk factors, including hypertension, diabetes, dyslipidemia, smoking, obesity, family history of CVD, physically inactivity, and poor diet, were collected from medical records, patient interviews, and examinations. Statistical analyses explored the relationship between the number of risk factors and both 6MWT performance and VO2max. Results: Among 679 participants, the mean age was 52.3 ± 10.2 years, with 80.1% being female. Hypertension, obesity, and smoking were the most prevalent risk factors. Over half (58.6%) had 4–6 risk factors. The average 6MWT distance was 379.0 ± 97.5 m, below the healthy range, and the average VO2max was 15.6 ± 5.3 ml/kg/min, indicating poor functional capacity in majority of the participants. Traditional risk factors, including sex, age, hypertension, diabetes, dyslipidemia, and physically inactivityhad a significant impact on 6MWT distance and estimated VO2max (p < 0.05). A strong positive correlation was found between VO2max and 6MWT distance (r = 0.90, 95%CI 0.88–0.91, p < 0.001), while a significant inverse relationship was noted between the number of cardiovascular risk factors and VO2max, with those having more than 6 risk factors showing significantly lower VO2max (p = 0.008). Conclusions: This study underscores the substantial impact of cardiovascular risk factors on functional capacity and aerobic fitness. The inverse relationship between the number of risk factors and VO2max highlights the critical need for early identification and proactive management to improve functional capacity and long-term health outcomes in at-risk populations. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12875-026-03515-y.
SN - 2731-4553
ER -