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Moderate to High Levels of Cardiorespiratory Fitness Attenuate the Effects of Triglyceride to High-Density Lipoprotein Cholesterol Ratio on Coronary Heart Disease Mortality in Men

Published:November 17, 2017DOI:https://doi.org/10.1016/j.mayocp.2017.08.015

      Abstract

      Objective

      To examine the prospective relationships among cardiorespiratory fitness (CRF), fasting blood triglyceride to high density lipoprotein cholesterol ratio (TG:HDL-C), and coronary heart disease (CHD) mortality in men.

      Methods

      A total of 40,269 men received a comprehensive baseline clinical examination between January 1, 1978, and December 31, 2010. Their CRF was determined from a maximal treadmill exercise test. Participants were divided into CRF categories of low, moderate, and high fit by age group and by TG:HDL-C quartiles. Hazard ratios for CHD mortality were computed using Cox regression analysis.

      Results

      A total of 556 deaths due to CHD occurred during a mean ± SD of 16.6±9.7 years (669,678 man-years) of follow-up. A significant positive trend in adjusted CHD mortality was shown across decreasing CRF categories (P for trend<.01). Adjusted hazard ratios were significantly higher across increasing TG:HDL-C quartiles as well (P for trend<.01). When grouped by CRF category and TG:HDL-C quartile, there was a significant positive trend (P=.04) in CHD mortality across decreasing CRF categories in each TG:HDL-C quartile.

      Conclusion

      Both CRF and TG:HDL-C are significantly associated with CHD mortality in men. The risk of CHD mortality in each TG:HDL-C quartile was significantly attenuated in men with moderate to high CRF compared with men with low CRF. These results suggest that assessment of CRF and TG:HDL-C should be included for routine CHD mortality risk assessment and risk management.

      Abbreviations and Acronyms:

      BMI (body mass index), CCLS (Cooper Center Longitudinal Study), CHD (coronary heart disease), CRF (cardiorespiratory fitness), CVD (cardiovascular disease), HDL-C (high-density lipoprotein cholesterol), HR (hazard ratio), LDL-C (low-density lipoprotein cholesterol), MET (metabolic equivalent), NHANES (National Health and Nutrition Examination Survey), TG:HDL-C (fasting triglyceride to high-density lipoprotein cholesterol ratio)
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