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

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 (VO 2 max) in a high-risk population at primary care centers. 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 VO 2 max 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 VO 2 max. 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 VO 2 max 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 VO 2 max ( p < 0.05). A strong positive correlation was found between VO 2 max 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 VO 2 max, with those having more than 6 risk factors showing significantly lower VO 2 max ( p = 0.008). 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 VO 2 max highlights the critical need for early identification and proactive management to improve functional capacity and long-term health outcomes in at-risk populations.