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Long-Term Benefit of Fitness in Healthy Individuals
Study Questions:
What is the association of cardiopulmonary exercise testing and cardiorespiratory fitness (CRF) on outcomes in healthy men and women?
Methods:
A total of 4,137 participants (2,326 men and 1,811 women) from ages 18-85 (mean age 42.8 ± 12.2 years) were included in the study at a single-center institution. All participants completed an assessment, including cardiopulmonary exercise (CPX) testing at enrollment to determine baseline CRF. Patients were excluded if life expectancy was >1 year and if they could not achieve a peak effort of respiratory exchange ratio ≥1 during CPX testing. All participants were followed from the date of initial CPX to death or through July 2017 for all-cause mortality or December 2015 for disease-specific mortality. Cox proportional hazard models were used to determine the relationship of CRF and CRF level (low, moderate, and high) with mortality outcomes.
Results:
The all-cause mortality rates declined across fitness levels. Overall, peak VO2 was inversely associated with risk for all-cause, cardiovascular disease (CVD), and cancer mortality after adjusting for age and sex (p < 0.05). There was a significant relationship between peak VO2 and CVD mortality in men. Low CRF was associated with higher risk for all-cause, CVD, and cancer mortality compared to high CRF. 1 MET increment in CRF was associated with a lower all-cause (12%), CVD (16%), and cancer (14%) mortality, independent of other risk factors.
Conclusions:
There is value in assessing CRF in healthy men and women as part of a clinical assessment.
Perspective:
Quantifying CRF in healthy individuals can help prognosticate long-term outcomes and can be used as a marker to help achieve improved preventative treatment goals.
Clinical Topics: Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Prevention, Sports and Exercise Cardiology, Exercise, Sports and Exercise and ECG and Stress Testing
Keywords: Cardiovascular Diseases, Exercise, Exercise Test, Life Expectancy, Metabolic Syndrome, Neoplasms, Physical Fitness, Primary Prevention, Respiratory Physiological Phenomena, Risk Factors
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