Abstract 1355: Lifetime Risk for Cardiovascular Disease Death for Fitness Levels in Adult Men: Findings From the Cooper Clinic Longitudinal Study
Background: Higher levels of traditional risk factors are associated with marked differences in lifetime risks for cardiovascular disease (CVD). However, data are sparse regarding the association between physical fitness and lifetime risks for CVD.
Methods: We followed 11,049 men who underwent clinical examination at the Cooper Clinic in Dallas, TX before 1990 until the occurrence of a CVD death, non-CVD death, or attainment of age 90 (281,469 person-years of follow-up, 1,106 CVD deaths). Physical fitness was measured by a maximal treadmill exercise test using a Balke protocol and categorized into three groups based on age- and sex-specific criteria: low, intermediate, and high fitness. Additional analyses were performed for those with very low fitness (≤6 METS). Lifetime risk for CVD death determined by the National Death Index was estimated for fitness levels measured at different ages (45-, 55-, and 65-years) with non-CVD death as the competing event. We also estimated median survival for each fitness group.
Results: Differences in fitness levels were associated with marked differences in lifetime risk for CVD death to age 80 at each index age. In addition, these differences in fitness translated into significant differences in median survival (see table⇓). For example, compared to men at age 55 years with high physical fitness, men with very low fitness had markedly higher lifetime risks for CVD death (28.7 % vs. 4.9 %) with markedly shorter survival (11 years). These associations persisted after additional stratification by traditional risk factor burden (data not shown).
Conclusions. To our knowledge, this represents the first reported association between fitness levels and lifetime risks for CVD as well as survival to old age. We believe that these findings could be useful for practicing clinicians as well as policymakers to facilitate more effective risk communication regarding the health benefits of physical fitness.