This study evaluated whether the 3-minute Step Test, a submaximal measure of cardiorespiratory fitness, can predict cardiometabolic and arterial health in youth with atherosclerosis-promoting cardiometabolic risk factors.

Children and adolescents attended a paediatric preventive cardiology clinic for management of cardiometabolic risk factors. Cardiorespiratory fitness was assessed using a 3-minute Step Test, where an individual steps up/down on a 6-inch step at 24 steps/min for 3 minutes. The percentage of age-predicted maximum heart rate that was attained at the end of the Step Test was recorded as a measure of physiological work (cardiorespiratory fitness). Lifestyle-influenced cardiometabolic risk factors included: body anthropometrics [body mass index z-score, waist-to-height ratio z-score], systolic blood pressure, and serum markers [triglycerides, high-density lipoprotein cholesterol, haemoglobin A1C, alanine aminotransferase, vitamin D]. Arterial function was assessed by measuring pulse wave velocity and was normalised to sex and height-specific z-score.

The sample included 482 patients [age 14.31 ± 2.38 years, 261 (53%) male]. A higher percent predicted peak heart rate strongly correlated with worse lifestyle-influenced cardiometabolic risk factors and with higher pulse wave velocity, suggesting increased arterial stiffness.

Percent predicted peak heart rate from the 3-minute Step Test was associated with cardiometabolic and arterial health. The 3-minute Step Test is an inexpensive, quick, and low-resource-intensive method to estimate cardiorespiratory fitness, cardiometabolic and arterial health in an outpatient clinical setting.