Author + information
- Received April 6, 2018
- Revision received August 17, 2018
- Accepted August 20, 2018
- Published online October 29, 2018.
- Mary T. Imboden, PhDa,
- Matthew P. Harber, PhDa,
- Mitchell H. Whaley, PhDb,
- W. Holmes Finch, PhDc,
- Derron L. Bishop, PhDd and
- Leonard A. Kaminsky, PhDe,∗ (, )@BSUHealth
- aClinical Exercise Physiology Laboratory, Ball State University, Muncie, Indiana
- bCollege of Health, Ball State University, Muncie, Indiana
- cDepartment of Educational Psychology, Ball State University, Muncie, Indiana
- dSchool of Medicine, Indiana University, Bloomington, Indiana
- eFisher Institute of Health and Well-Being, Ball State University, Muncie, Indiana
- ↵∗Address for correspondence:
Dr. Leonard A. Kaminsky, Fisher Institute of Health and Well-Being, Ball State University, 2000 University Avenue, Muncie, Indiana 47306.
Background There is a well-established inverse relationship between cardiorespiratory fitness (CRF) and mortality. However, this relationship has almost exclusively been studied using estimated CRF.
Objectives This study aimed to assess the association of directly measured CRF, obtained using cardiopulmonary exercise (CPX) testing with all-cause, cardiovascular disease (CVD), and cancer mortality in apparently healthy men and women.
Methods Participants included 4,137 self-referred apparently healthy adults (2,326 men, 1,811 women; mean age: 42.8 ± 12.2 years) who underwent CPX testing to determine baseline CRF. Participants were followed for 24.2 ± 11.7 years (1.1 to 49.3 years) for mortality. Cox-proportional hazard models were performed to determine the relationship of CRF (ml·kg-1·min-1) and CRF level (low, moderate, and high) with mortality outcomes.
Results During follow-up, 727 participants died (524 men, 203 women). CPX-derived CRF was inversely related to all-cause, CVD, and cancer mortality. Low CRF was associated with higher risk for all-cause (hazard ratio [HR]: 1.73; 95% confidence interval [CI]: 1.20 to 3.50), CVD (HR: 2.27; 95% CI: 1.20 to 3.49), and cancer (HR: 2.07; 95% CI: 1.18 to 3.36) mortality compared with high CRF. Further, each metabolic equivalent increment increase in CRF was associated with a 11.6%, 16.1%, and 14.0% reductions in all-cause, CVD, and cancer mortality, respectively.
Conclusions Given the prognostic ability of CPX-derived CRF for all-cause and disease-specific mortality outcomes, its use should be highly considered for apparently healthy populations as it may help to improve the efficacy of the individualized patient risk assessment and guide clinical decisions.
Support for this project was provided, in part, from American Heart Association Award #18AIREA33930023 (M.P.H., principal investigator). Dr. Kaminsky serves as a scientific advisor for ENDO Medical, Inc. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received April 6, 2018.
- Revision received August 17, 2018.
- Accepted August 20, 2018.
- 2018 American College of Cardiology Foundation
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