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Sex- and age-specific associations between cardiorespiratory fitness, CVD morbidity and all-cause mortality in 266.109 adults

Journal article
Authors E. Ekblom-Bak
B. Ekblom
J. Soderling
Mats Börjesson
V. Blom
L. V. Kallings
E. Hemmingsson
G. Andersson
P. Wallin
O. Ekblom
Published in Preventive Medicine
Volume 127
ISSN 0091-7435
Publication year 2019
Published at Institute of Neuroscience and Physiology
Department of Food and Nutrition, and Sport Science
Language en
Links dx.doi.org/10.1016/j.ypmed.2019.105...
Keywords Cardiovascular disease, Cancer, Aerobic capacity, VO(2)max, Population, Risk, physical-activity, healthy-men, follow-up, cardiovascular health, heart-failure, exercise, risk, modalities, predictor, events, Public, Environmental & Occupational Health, General & Internal Medicine
Subject categories Environmental Health and Occupational Health

Abstract

The aim was to investigate sex- and age-specific associations between cardiorespiratory fitness, all-cause and cause-specific mortality, and cardiovascular disease (CVD) morbidity. 266.109 participants (47% women, 18-74 years) free from CVD, participating in occupational health service screenings in 1995-2015 were included. CRF was assessed as estimated maximal oxygen consumption (estVO(2)max) using a submaximal cycle test. Incident cases of first-time CVD event and death from any cause were ascertained through national registers. There were 4244 CVD events and 2750 cases of all-cause mortality during mean 7.6 years follow-up. Male gender, higher age and lower estVO(2)max were associated with higher all-cause mortality and CVD morbidity incidence rates. Risk reductions with increasing estVO(2)max were present in all age-groups of men and women. No obvious levelling off in risk was identified in the total cohort. However, women and older age-groups showed no further reduction in higher aggregated estVO(2)max levels. CVD specific mortality was more associated with estVO(2)max compared to tumor specific mortality. The risk for all-cause mortality and CVD morbidity decreased by 2.3% and 2.6% per increase in 1 ml.min(-) (1).kg(-1) with no significant sex-differences but more pronounced in the three lower estVO(2)max categories for all-cause mortality (9.1%, 3.8% and 3.3%, respectively). High compared to lower levels of estVO(2)max was not related to a significantly elevated mortality or morbidity. In this large cohort study, CVD morbidity and all-cause mortality were inversely related to estVO(2)max in both men and women of all age-groups. Increasing cardiorespiratory fitness is a clear public health priority.

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