Association between cardiorespiratory fitness and trend of age-related rise in arterial stiffness in individuals with and without hypertension or diabetes

Abstract Background This study aimed to investigate whether higher cardiorespiratory fitness (CRF) can modify the trend of age-related rise in arterial stiffness in individuals with and without hypertension (HTN) or diabetes. Methods The study included 4,935 participants who underwent maximal cardiopulmonary exercise testing with respiratory gas analysis in a health screening program. CRF was directly measured using peak oxygen uptake during the cardiopulmonary exercise test, while arterial stiffness was evaluated using brachial-ankle pulse wave velocity (baPWV). Results Participants with high CRF levels had significantly lower baPWV compared to those with low CRF levels, regardless of HTN or diabetes status (p<0.05). The trend of baPWV increased with age, but the rate of age-related increase in baPWV was lower in individuals with moderate to high CRF levels compared to those with low CRF levels, regardless of HTN or diabetes status. Joint association analysis indicated that the trend of age-related increase in baPWV was the lowest in fit individuals without HTN or diabetes compared to unfit individuals with HTN or diabetes (p<0.01). However, the trend of age-related increase in baPWV was not attenuated in fit with HTN or diabetes compared to unfit with HTN or diabetes. Conclusions These findings suggest that higher CRF levels may mitigate the trend of age-related rise in arterial stiffness in individuals with and without HTN or diabetes. However, this attenuating trend appears more pronounced in individuals without HTN or diabetes.