July 17, 1996JAMA
Influences of Cardiorespiratory Fitness and Other Precursors on Cardiovascular Disease and All-Cause Mortality in Men and Women
Why the study?
Does moderate to high cardiorespiratory fitness reduce cardiovascular disease and all-cause mortality in men and women?
Population
32,421 participants who completed preventive medical examinations, including a maximal exercise test.
Comparison
Moderate to high cardiorespiratory fitness vs Low cardiorespiratory fitness (least fit 20%)
Design
Cohort
Follow-up
211,996 man-years and 52,982 woman-years
Authors
Discussion
Loading...
Member takes
Implication
Fitness assessment may refine mortality risk stratification; leaves open whether improving fitness alters outcomes.
Key Points
- To quantify the association between cardiorespiratory fitness and cardiovascular disease or all-cause mortality across different strata of established health and cardiovascular risk factors.
- Observational cohort study of 25,341 men and 7,080 women evaluated at a preventive medicine clinic who completed a maximal exercise test.
- Tracked mortality across 211,996 man-years (601 deaths) and 52,982 woman-years (89 deaths), categorizing fitness into low (lowest 20%), moderate (middle 40%), and high (top 40%).
- Low fitness independently predicted increased mortality in both men (adjusted RR, 1.52; 95% CI, 1.28–1.82) and women (adjusted RR, 2.10; 95% CI, 1.36–3.21).
- Additional independent predictors in men were smoking (RR, 1.65; 95% CI, 1.39–1.97), abnormal electrocardiogram (RR, 1.64; 95% CI, 1.34–2.01), chronic illness (RR, 1.63; 95% CI, 1.37–1.95), elevated cholesterol (RR, 1.34; 95% CI, 1.13–1.59), and elevated systolic blood pressure (RR, 1.34; 95% CI, 1.13–1.59), whereas smoking was the only other independent predictor in women (RR, 1.99; 95% CI, 1.25–3.17).
- Fit individuals presenting with smoking, elevated blood pressure, or high cholesterol had lower adjusted death rates than low-fitness individuals with none of these conditions.
Structured PICO
Does moderate to high cardiorespiratory fitness reduce cardiovascular disease and all-cause mortality in men and women?
P
Population
32,421 participants (25,341 men and 7,080 women) who completed preventive medical examinations, including a maximal exercise test.
I
Intervention
Moderate to high cardiorespiratory fitness (measured by maximal exercise test)
C
Comparator
Low cardiorespiratory fitness (least fit 20%)
O
Outcome
Cardiovascular disease and all-cause mortalityhard clinical
Low cardiorespiratory fitness is an independent predictor of mortality in both men and women, and moderate fitness protects against the influence of other mortality predictors.
Cite This Study
Steven N. Blair (1996) studied this question.