Cardiovascular Fitness As A Predictor Of Mortality In Men - Brief Article

Nutrition Research Newsletter, April, 2001

Physical inactivity has been estimated to account for 12% of all deaths in the United States. It is considered to be one of the most crucial public health problems. Low cardiorespiratory fitness has been associated with an increased risk of premature death in prospective population-based studies. This has been primarily due to cardiovascular disease (CVD) -- related mortality. Recommendations concerning the specific quantity and intensity of physical activity and the level of cardiorespiratory fitness needed to reduce premature mortality are based on few studies. The present study examines the associations of cardiorespiratory fitness, as indicated by directly measured [VO.sub.2] max, and exercise test duration with mortality not only from CVDs, but also from other causes, in a population-based sample of men from eastern Finland.

Subjects were participants in the Kuopio Ischaemic Heart Disease Risk Factor Study. The study was designed to investigate risk factors for CVD, atherosclerosis, and related outcomes in a population-based, randomly selected sample of men in eastern Finland. For the present study, a population-based cohort of 1294 men with no CVD, pulmonary disease, or cancer at baseline in Kuopio were selected. Cardio-respiratory fitness was assessed with a maximal, symptom-limited exercise tolerance test on an electrically braked bicycle ergometer as the initiation of the study. At the beginning of follow-up, the mean age of the subjects was 52.1 years and the mean [VO.sub.2] max was 32.7 mL/kg per minute, and the mean exercise duration was 9.7 minutes.

Maximal oxygen uptake was associated directly with serum high-density lipoprotein cholesterol level and exercise test duration and inversely associated with cigarette smoking, alcohol consumption, body mass index, waist-hip ratio, systolic and diastolic blood pressure, diabetes, fasting serum insulin level, plasma fibrinogen level, serum total and low-density lipoprotein cholesterol level, and triglycerides level. Low cardiorespiratory fitness and a short exercise test duration were both related to increased risk of overall mortality. Low [VO.sub.2] max was associated with a 2.76-fold risk of overall mortality after adjusting for age, examination years, smoking, and alcohol consumption. High systolic blood pressure, smoking, obesity, and diabetes were associated with an increased risk of all-cause and CVD-related mortality.

In middle-aged men, [VO.sub.2] max and exercise test duration had a strong, graded, and inverse association with overall, CVD-related, and non-CVD-related mortality. [VO.sub.2] max and exercise test duration were two of the strongest predictors for mortality in this cohort. Every US adult should accumulate 30 minutes or more of moderate-intensity physical activity on most, preferably all, days of the week to prevent chronic disease.

J. Laukkanen, T. Lakka, R. Rauramaa, R. Kuhanen, J. Venalainen, R. Salonen, J. Salonen. Cardiovascular Fitness as a Predictor of Mortality in Men. Arch Intern Med 161(6):825-831 (March 2001) [Correspondence: Jukka T. Salonen, MD, PhD, MSPH, Research Institute of Public Health, University of Kuopio, PO Box 1627, Harjulantie 1B, 70211 Kuopio, Finland. E-mail: jukka.salonen@uku.fi].