Background Despite many studies suggesting that poor physicalfitness is an independent risk factor for death from cardiovascularcauses, the matter has remained controversial. We studied thisquestion in a 16-year follow-up investigation of Norwegian menthat began in 1972.
Methods Our study included 1960 healthy men 40 to 59 years ofage (84 percent of those invited to participate). Conventionalcoronary risk factors and physical fitness were assessed atbase line, with physical fitness measured as the total workperformed on a bicycle ergometer during a symptom-limited exercise-tolerancetest.
Results After an average follow-up time of 16 years, 271 menhad died, 53 percent of them from cardiovascular disease. Therelative risk of death from any cause in fitness quartile 4(highest) as compared with quartile 1 (lowest) was 0.54 (95percent confidence interval, 0.32 to 0.89; P = 0.015) afteradjustment for age, smoking status, serum lipids, blood pressure,resting heart rate, vital capacity, body-mass index, level ofphysical activity, and glucose tolerance. Total mortality wassimilar among the subjects in fitness quartiles 1, 2, and 3when the data were adjusted for these same variables.
The adjusted relative risk of death from cardiovascular causesin fitness quartile 4 as compared with quartile 1 was 0.41 (95percent confidence interval, 0.20 to 0.84; P = 0.013). The correspondingrelative risks for quartiles 3 and 2 (as compared with quartile1) were 0.45 (95 percent confidence interval, 0.22 to 0.92;P = 0.026) and 0.59 (95 percent confidence interval, 0.28 to1.22; P = 0.15), respectively.
Conclusions Physical fitness appears to be a graded, independent,long-term predictor of mortality from cardiovascular causesin healthy, middle-aged men. A high level of fitness was alsoassociated with lower mortality from any cause.
Source Information
From the Medical Department, Central Hospital of Akershus, Nordbyhagen, Norway (L.S., J.E., G.E.), and the National University Hospital (E.T.), the Ullevaal Hospital (R.M.), and the Department of Work Physiology, University of Oslo (K.R.) -- all in Oslo, Norway.
Address reprint requests to Dr. Jan Erikssen at the Medical Department, Central Hospital of Akershus, N-1474 Nordbyhagen, Norway.
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