Authors
Blair SN. Kampert JB. Kohl HW 3rd. Barlow CE. Macera CA. Paffenbarger RS
Jr. Gibbons LW.
Institution
Cooper Institute for Aerobics Research, Dallas, Tex 75230, USA.
steve0704:aol.com
Title
Influences of cardiorespiratory fitness and
other precursors on cardiovascular disease and all-cause mortality in men and
women.
Source
JAMA. 276(3):205-10, 1996 Jul 17.
Abstract
OBJECTIVE: To quantify the relation of cardiorespiratory
fitness to cardiovascular disease (CVD) mortality and to
all-cause mortality within strata of other personal characteristics that
predispose to early mortality. DESIGN--Observational cohort study. We
calculated CVD and all-cause death rates for low (least fit 20%), moderate
(next 40%), and high (most fit 40%) fitness categories by
strata of smoking habit, cholesterol level, blood pressure, and health
status. SETTING: Preventive medicine clinic. STUDY PARTICIPANTS: Participants
were 25341 men and 7080 women who completed preventive medical examinations,
including a maximal exercise test. MAIN OUTCOME MEASURES: Cardiovascular
disease and all-cause mortality. RESULTS: There were 601 deaths during 211996
man-years of follow-up, and 89 deaths during 52982 woman-years of follow-up.
Independent predictors of mortality among men, with adjusted relative risks
(RRs) and 95% confidence intervals (CIs), were low fitness
(RR, 1.52;95% CI, 1.28-1.82), 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), increased cholesterol level (RR, 1.34; 95% CI, 1.13-1.59),
and elevated systolic blood pressure (RR, 1.34; 95% CI, 1.13-1.59). The only
statistically significant independent predictors of mortality in women were
low fitness (RR, 2.10; 95% Cl, 1.36-3.21) and smoking (RR,
1.99; 95% Cl, 1.25-3.17). Inverse gradients were seen for mortality across
fitness categories within strata of other mortality
predictors for both sexes. Fit persons with any combination of smoking,
elevated blood pressure, or elevated cholesterol level had lower adjusted
death rates than low-fit persons with none of these characteristics.
CONCLUSIONS: Low fitness is an important precursor of
mortality. The protective effect of fitness held for smokers
and nonsmokers, those with and without elevated cholesterol levels or
elevated blood pressure, and unhealthy and healthy persons. Moderate
fitness seems to protect against the influence of these
other predictors on mortality. Physicians should encourage sedentary patients
to become physically active and thereby reduce the risk of premature
mortality.