Association of Cardiorespiratory Fitness With Coronary Heart Disease in Asymptomatic Men

Gander, Jennifer C., Sui, Xuemei, Hebert, James R., Hazlett, Linda J., Cai, Bo, Lavie, Carl J. and Blair, Steven N. (2015) Association of Cardiorespiratory Fitness With Coronary Heart Disease in Asymptomatic Men. Mayo Clinic Proceedings, 90 10: 1372-1379. doi:10.1016/j.mayocp.2015.07.017

Author Gander, Jennifer C.
Sui, Xuemei
Hebert, James R.
Hazlett, Linda J.
Cai, Bo
Lavie, Carl J.
Blair, Steven N.
Title Association of Cardiorespiratory Fitness With Coronary Heart Disease in Asymptomatic Men
Journal name Mayo Clinic Proceedings   Check publisher's open access policy
ISSN 0025-6196
Publication date 2015-10-01
Year available 2015
Sub-type Article (original research)
DOI 10.1016/j.mayocp.2015.07.017
Open Access Status Not Open Access
Volume 90
Issue 10
Start page 1372
End page 1379
Total pages 8
Place of publication New York, NY United States
Publisher Elsevier
Language eng
Formatted abstract
To examine the association of cardiorespiratory fitness (CRF) with risk of coronary heart disease (CHD) while controlling for an individual's Framingham Risk Score (FRS)–predicted CHD risk.

Patients and Methods
The study included 29,854 men from the Aerobics Center Longitudinal Study, who received a baseline examination from January 1, 1979, to December 31, 2002. Coronary heart disease events included self-reported myocardial infarction or revascularization or CHD death. Multivariable survival analysis investigated the association between CRF, FRS, and CHD. Cardiorespiratory fitness was analyzed as both a continuous and a categorical variable. The population was stratified by “low” and “moderate or high” risk of CHD to test for differences in the FRS stratified by CRF.

Compared with men without incident CHD, men with incident CHD were older (mean age, 51.6 years vs 44.6 years), had lower average maximally achieved fitness (10.9 metabolic equivalent of tasks vs 12.0 metabolic equivalent of tasks [METs]), and were more likely to have moderate or high 10-year CHD risk (P<.001). Cardiorespiratory fitness, defined as maximal METs, exhibited a 20% lower risk of CHD (hazard ratio, 0.80; 95% CI, 0.77-0.83) for each 1-unit MET increase. Among men in the low CRF strata, individuals with moderate or high 10-year CHD risk, according to the FRS, had a higher CHD risk (hazard ratio, 6.55; 95% CI, 3.64-11.82) than men with low CHD risk according to the FRS.

Clinicians should promote physical activity to improve CRF so as to reduce CHD risk, even to patients with otherwise low CHD risk.
Keyword All Cause Mortality
Cardiovascular Risk Profile
Physical fitness
Myocardial infarction
Artery Disease
Q-Index Code C1
Q-Index Status Confirmed Code
Grant ID AG06945
K05 CA136975
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
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