fitness and mortality

From: Doug Skrecky (oberon@vcn.bc.ca)
Date: Thu Nov 19 1998 - 22:45:33 MST


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.



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