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Medicine & Science in Sports & Exercise:
Epidemiology

Influences of cardiorespiratory fitness levels and other predictors on cardiovascular disease mortality in men

FARRELL, STEPHEN W.; KAMPERT, JAMES B.; KOHL, HAROLD W. III; BARLOW, CAROLYN E.; MACERA, CAROLINE A.; PAFFENBARGER, RALPH S. JR.; GIBBONS, LARRY W.; BLAIR, STEVEN N.

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Abstract

Influences of cardiorespiratory fitness levels and other predictors on cardiovascular disease mortality in men. Med. Sci. Sports Exerc., Vol. 30, No. 6, pp. 899-905, 1998.

Purpose: This investigation quantifies the relation between cardiorespiratory fitness levels and cardiovascular disease (CVD) mortality within strata of other CVD predictors.

Methods: Participants included 25,341 male Cooper Clinic patients who underwent a maximal graded exercise test. CVD death rates were determined for low (least fit one-fifth), moderate (next two-fifths), and high (top two-fifths) cardiorespiratory fitness categories by strata of smoking habit, blood cholesterol level, resting blood pressure, and health status. There were 226 cardiovascular deaths during 211,996 man-years of follow-up.

Results: For individuals with none of the major CVD predictors (smoking, elevated resting systolic blood pressure, elevated blood cholesterol), there was a strong inverse relation (P = 0.001) between fitness level and CVD mortality. An inverse relation between CVD mortality and fitness level was seen within strata of cholesterol levels and health status. No evidence of a trend (P = 0.60) for decreased mortality was seen across fitness levels for individuals with elevated systolic blood pressure; however, a strong inverse gradient (P < 0.001) was seen across fitness levels for individuals with normal systolic blood pressure. There was a tendency for association between high levels of fitness and decreased CVD mortality in smokers compared with low and moderately fit smokers (P < 0.076). There was no significant association between level of fitness and CVD mortality for individuals with multiple (two or more) predictors (P = 0.325). Approximately 20% of the 226 CVD deaths in the population studied were attributed to low fitness level.

Conclusions: Moderate and high levels of cardiorespiratory fitness seem to provide some protection from CVD mortality, even in the presence of well established CVD predictors.

© Williams & Wilkins 1998. All Rights Reserved.

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