A decline in cardiorespiratory fitness of >2.0 METS was associated with a 74% increase in all-cause mortality risk for low-fit individuals with CVD (HR 1.74; 95% CI 1.59-1.91).
Cohort (n=93,060)
Hazard Ratio: 1.74 (95% CI 1.59–1.91)
BACKGROUND The association between cardiorespiratory fitness (CRF) and mortality risk is based mostly on 1 CRF assessment. The impact of CRF change on mortality risk is not well-defined. OBJECTIVES This study sought to evaluate changes in CRF and all-cause mortality. METHODS We assessed 93,060 participants aged 30-95 years (mean 61.3 ± 9.8 years). All completed 2 symptom-limited exercise treadmill tests, 1 or more years apart (mean 5.8 ± 3.7 years) with no evidence of overt cardiovascular disease. Participants were assigned to age-specific fitness quartiles based on peak METS achieved on the baseline exercise treadmill test. Additionally, each CRF quartile was stratified based on CRF changes (increase, decrease, no change) observed on the final exercise treadmill test. Multivariable Cox models were used to estimate HRs and 95% CIs for all-cause mortality. RESULTS During a median follow-up of 6.3 years (IQR: 3.7-9.9 years), 18,302 participants died with an average yearly mortality rate of 27.6 events per 1,000 person-years. In general, changes in CRF ≥1.0 MET were associated with inverse and proportionate changes in mortality risk regardless of baseline CRF status. For example, a decline in CRF of >2.0 METS was associated with a 74% increase in risk (HR: 1.74; 95% CI: 1.59-1.91) for low-fit individuals with CVD, and 69% increase (HR: 1.69; 95% CI: 1.45-1.96) for those without CVD. CONCLUSIONS Changes in CRF reflected inverse and proportional changes in mortality risk for those with and without CVD. The impact of relatively small CRF changes on mortality risk has considerable clinical and public health significance.
“Even a little bit of fitness, like a brisk walk most days of the week for approximately 30 minutes, may be the most effective way and perhaps the least expensive way to promote health for all ages. I think it's important to emphasize to the public that it really doesn't take a whole lot to reap the benefits of exercise.”
Kokkinos et al. (Wed,) conducted a cohort in With or without cardiovascular disease (n=93,060). Change in cardiorespiratory fitness (CRF) vs. No change in CRF was evaluated on All-cause mortality (HR 1.74, 95% CI 1.59-1.91). A decline in cardiorespiratory fitness of >2.0 METS was associated with a 74% increase in all-cause mortality risk for low-fit individuals with CVD (HR 1.74; 95% CI 1.59-1.91).