Abstract P135: Cardiorespiratory Fitness and All-cause Mortality in Men with Emotional Problems
Introduction: Mental health disorders are often associated with higher mortality risk. Whether higher cardiorespiratory fitness (CRF) reduces risk for all-cause mortality in individuals with emotional problems is poorly understood.
Hypothesis: We assessed the hypothesis that higher CRF was associated with a lower risk of dying in a group of middle-aged men who enrolled in the Aerobics Center Longitudinal Study.
Methods: Participants were 5,240 men (mean±SD age 46.5±9.5 years) who completed an extensive medical examination between 1987 and 2002 andwere followed for mortality. At baseline, all participants were free of known myocardial infarction and stroke, had emotional problems (including depression, anxiety, thoughts of suicide, or psychiatric or psychological counseling) on the basis of a history of physician diagnosis, and were able to complete the exercise test to at least 85% of their age-predicted maximal heart rate. CRF was quantified as maximal treadmill exercise test duration and was grouped for analysis as low (lowest 20% of exercise duration), moderate (middle 40%), and high (upper 40%). Mortality surveillance was completed through December 31, 2003. Cox regression was used to quantify the magnitude of association between CRF and all-cause mortality.
Results: A total of 128 deaths occurred during an average of 8.8 years of follow-up and 46,217 man-years of observation. Age- and examination year- adjusted mortality rates per 10,000 man-years according to low, moderate, and high CRF groups were 64.7, 28.0, and 19.6 (trend P < 0.0001). After additional adjustment for body mass index; smoking; alcohol intake; physical activity; abnormal resting or exercise electrocardiogram responses; the presence of diabetes, hypertension and hypercholesterolemia; and family history of cardiovascular disease (CVD), the inverse association between CRF and mortality was attenuated, but remained significant. The hazard ratios (HRs) and 95% confidence intervals (CIs) across incremental CRF categories were 1.00 (referent), 0.53 (0.31-0.89), and 0.47 (0.26-0.84), trend P =0.02. After stratifying data by age, CVD risk factors, and depression status, the inverse association between CRF and death was observed in younger men (age<55), men with CVD risk factors (hypertension, diabetes, hypercholesterolemia, smoking, or family history), and in depressed men, respectively (all trend P<0.05).
Conclusions: Among men with emotional problems, higher CRF is associated with lower risk of dying, independent of other clinical mortality predictors. Our findings underscore the importance of promoting physical activity to maintain a healthful level of CRF in individuals with emotional problems.
- © 2013 by American Heart Association, Inc.