Abstract
Objective
To examine the association of cardiorespiratory fitness (CRF) with risk of coronary
heart disease (CHD) while controlling for an individual's Framingham Risk Score (FRS)–predicted
CHD risk.
Patients and Methods
The study included 29,854 men from the Aerobics Center Longitudinal Study, who received
a baseline examination from January 1, 1979, to December 31, 2002. Coronary heart
disease events included self-reported myocardial infarction or revascularization or
CHD death. Multivariable survival analysis investigated the association between CRF,
FRS, and CHD. Cardiorespiratory fitness was analyzed as both a continuous and a categorical
variable. The population was stratified by “low” and “moderate or high” risk of CHD
to test for differences in the FRS stratified by CRF.
Results
Compared with men without incident CHD, men with incident CHD were older (mean age,
51.6 years vs 44.6 years), had lower average maximally achieved fitness (10.9 metabolic
equivalent of tasks vs 12.0 metabolic equivalent of tasks [METs]), and were more likely
to have moderate or high 10-year CHD risk (P<.001). Cardiorespiratory fitness, defined as maximal METs, exhibited a 20% lower
risk of CHD (hazard ratio, 0.80; 95% CI, 0.77-0.83) for each 1-unit MET increase.
Among men in the low CRF strata, individuals with moderate or high 10-year CHD risk,
according to the FRS, had a higher CHD risk (hazard ratio, 6.55; 95% CI, 3.64-11.82)
than men with low CHD risk according to the FRS.
Conclusion
Clinicians should promote physical activity to improve CRF so as to reduce CHD risk,
even to patients with otherwise low CHD risk.
Abbreviations and Acronyms:
ACLS (Aerobics Center Longitudinal Study), CHD (coronary heart disease), CRF (cardiorespiratory fitness), CVD (cardiovascular disease), FRS (Framingham Risk Score), HDL-C (high-density lipoprotein cholesterol), HR (hazard ratio), MET (metabolic equivalent of task)To read this article in full you will need to make a payment
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Article Info
Footnotes
Grant Support: This work was supported by the National Institutes of Health (grant nos. AG06945 , HL62508 , and DK088195 ). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Dr Hébert was supported by an Established Investigator Award in Cancer Prevention and Control from the Cancer Training Branch of the National Cancer Institute (award no. K05 CA136975).
Identification
Copyright
© 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
