Cardiorespiratory Fitness and Mortality Risk Across the Spectra of Age, Race, and Sex

医学 心肺适能 百分位 人口学 内科学 老年学 数学 统计 社会学
作者
Peter Kokkinos,Charles Faselis,Immanuel Babu Henry Samuel,Andreas Pittaras,Michael Doumas,Rayelynn Murphy,Michael S. Heimall,Xuemei Sui,Jiajia Zhang,Jonathan Myers
出处
期刊:Journal of the American College of Cardiology [Elsevier BV]
卷期号:80 (6): 598-609 被引量:153
标识
DOI:10.1016/j.jacc.2022.05.031
摘要

Cardiorespiratory fitness (CRF) is inversely associated with all-cause mortality. However, the association of CRF and mortality risk for different races, women, and elderly individuals has not been fully assessed.The aim of this study was to evaluate the association of CRF and mortality risk across the spectra of age, race, and sex.A total of 750,302 U.S. veterans aged 30 to 95 years (mean age 61.3 ± 9.8 years) were studied, including septuagenarians (n = 110,637), octogenarians (n = 26,989), African Americans (n = 142,798), Hispanics (n = 35,197), Native Americans (n = 16,050), and women (n = 45,232). Age- and sex-specific CRF categories (quintiles and 98th percentile) were established objectively on the basis of peak METs achieved during a standardized exercise treadmill test. Multivariable Cox models were used to estimate HRs and 95% CIs for mortality across the CRF categories.During follow-up (median 10.2 years, 7,803,861 person-years of observation), 174,807 subjects died, averaging 22.4 events per 1,000 person-years. The adjusted association of CRF and mortality risk was inverse and graded across the age spectrum, sex, and race. The lowest mortality risk was observed at approximately 14.0 METs for men (HR: 0.24; 95% CI: 0.23-0.25) and women (HR: 0.23; 95% CI: 0.17-0.29), with no evidence of an increase in risk with extremely high CRF. The risk for least fit individuals (20th percentile) was 4-fold higher (HR: 4.09; 95% CI: 3.90-4.20) compared with extremely fit individuals.The association of CRF and mortality risk across the age spectrum (including septuagenarians and octogenarians), men, women, and all races was inverse, independent, and graded. No increased risk was observed with extreme fitness. Being unfit carried a greater risk than any of the cardiac risk factors examined.
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