Abstract 2453: Exercise Capacity is Inversely Associated with Mortality Risk in Pre-Hypertensive Men
Introduction: Epidemiologic evidence supports an inverse and strong association between fitness status, and mortality in healthy individuals. Pre-hypertensive individuals are at increased risk for cardiovascular events compared to those with normal blood pressure. However, there is no information on the association between exercise capacity and mortality in pre-hypertensive individuals.
Methods: We assessed the association between peak exercise capacity (METs) and all-cause mortality in pre-hypertensive men (n=4,735; age=56±12). We established four fitness categories based on the MET level achieved. Those who achieved <5 METs (n=674); 5–7 METs (n=1,170); 7.1 to 10 METs (1,784); and > 10 METs (n= n=1,107). There were 943 deaths over 22 years of follow-up (mean=8.0±5.5).
Results: After adjusting for age, BMI, diabetes and dyslipidemia, exercise capacity was the strongest predictor of risk for mortality. The adjusted risk was reduced by 14% for every 1-MET increase in exercise capacity (Hazard Ratio= 0.86; CI: 0.84 – 0.88; p<0.001). When compared to those who achieved ≥5 METs, the mortality risk in those who achieved 5.1–7 METs was 25% lower (hazard ratio= 0.75; CI: 0.64 – 0.87; p<0.001); 60% lower for those who achieved 7.1–10 METs (hazard ratio= 0.40; CI: 0.33– 0.48; p<0.001), and 75% lower for those achieving >10 METs (Hazard Ratio= 0.25; CI: 0.19 – 0.33; p<0.001).
Conclusions: The association between exercise capacity and mortality in pre-hypertensive individuals was strong, inverse and graded. The mortality risk was lowered by 14% for each 1-MET increase in exercise capacity. The overall reduction in mortality was 25% to 75% for those with an exercise capacity of >7 METs compared to those who achieved <5 METs.