Key result
Middle-third cardiorespiratory fitness is linked to ~42% lower aortic stenosis risk versus the bottom third.
Why the study?
Cardiorespiratory fitness is a major risk factor for atherosclerotic cardiovascular disease, but its relationship with the risk of aortic stenosis had not been investigated.
Does higher cardiorespiratory fitness reduce the risk of incident aortic stenosis in middle-aged and older men?
Cohort (n=2,308)
Does higher cardiorespiratory fitness reduce the risk of incident aortic stenosis in middle-aged and older men?
Hazard Ratio: 0.58 (95% CI 0.34–0.97)
Moderate levels of cardiorespiratory fitness may be associated with a reduced risk of incident aortic stenosis in middle-aged men, though the dose-response relationship requires further study.
Moderate fitness may link to lower aortic stenosis risk in men; leaves open dose-response, causality, and need for trials.
Cardiorespiratory fitness (CRF) is a major risk factor and predictor of atherosclerotic cardiovascular disease. However, the relationship between CRF and risk of aortic stenosis (AS) has not been previously investigated. Thus, we aimed to assess the prospective association between CRF and risk of AS. CRF, as measured by maximal oxygen uptake, was assessed using a respiratory gas exchange analyzer during cardiopulmonary exercise testing in 2,308 men aged 42 to 61 years recruited into the Kuopio Ischemic Heart Disease prospective cohort study. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated for AS. During a median follow-up of 27 years, 101 cases of AS occurred. Dose-response analysis suggested there might be a nonlinear relation between CRF levels and AS risk. In an analysis adjusted for age, body mass index, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, smoking, history of type 2 diabetes mellitus, and coronary heart disease, the HRs 95% (CIs) of AS were 0.57 (0.34 to 0.96) and 0.91 (0.53 to 1.57) for participants in the middle and upper third of CRF levels, respectively, compared with participants in the bottom third. After further adjustment for alcohol consumption, the corresponding HRs (95% CIs) were 0.58 (0.34 to 0.97) and 0.91 (0.53 to 1.56), respectively. In conclusion, higher CRF levels may be associated with a lower incidence of AS in middle-aged and older Finnish men. Given the likely limitations of low statistical power, further research is needed to provide insights into the dose-response nature of any relationship between CRF and AS.
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Laukkanen et al. (2023) conducted a cohort in Aortic stenosis (n=2,308). Cardiorespiratory fitness vs. Bottom third of cardiorespiratory fitness levels was evaluated on Aortic stenosis (HR 0.58, 95% CI 0.34-0.97). Middle-third cardiorespiratory fitness levels were associated with a lower risk of aortic stenosis compared to the bottom third (HR 0.58; 95% CI 0.34-0.97) over a median 27-year follow-up.
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