The value of fitness

This study differs from previous studies because they have data on fitness (the treadmill performance) rather than patient reports on exercise. The study population included 122?007 patients (mean [SD] age, 53.4?[12.6] years; 72 173 [59.2%] male). Death occurred in 13?637 patients during 1.1 million person-years of observation. Risk-adjusted all-cause mortality was inversely proportional to cardiorespiratory fitness and was lowest in elite performers (elite vs low: adjusted hazard ratio [HR], 0.20; 95% CI, 0.16-0.24; P?<?.001; elite vs high: adjusted HR, 0.77; 95% CI, 0.63-0.95; P?=?.02). The increase in all-cause mortality associated with reduced cardiorespiratory fitness (low vs elite: adjusted HR, 5.04; 95% CI, 4.10-6.20; P?<?.001; below average vs above average: adjusted HR, 1.41; 95% CI, 1.34-1.49; P?<?.001) was comparable to or greater than traditional clinical risk factors (coronary artery disease: adjusted HR, 1.29; 95% CI, 1.24-1.35; P?<?.001; smoking: adjusted HR, 1.41; 95% CI, 1.36-1.46; P?<?.001; diabetes: adjusted HR, 1.40; 95% CI, 1.34-1.46; P?<?.001). In subgroup analysis, the benefit of elite over high performance was present in patients 70 years or older (adjusted HR, 0.71; 95% CI, 0.52-0.98; P?=?.04) and patients with hypertension (adjusted HR, 0.70; 95% CI, 0.50-0.99; P?=?.05). Extreme cardiorespiratory fitness (?2 SDs above the mean for age and sex) was associated with the lowest risk-adjusted all-cause mortality compared with al...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs