Document Detail

Characterizing differences in mortality at the low end of the fitness spectrum.
MedLine Citation:
PMID:  19568203     Owner:  NLM     Status:  MEDLINE    
PURPOSE: A graded nonlinear relationship exists between fitness and mortality with the most remarkable difference in mortality rates observed between the least-fit (first, Q1) and the next-least-fit (second, Q2) quintile of fitness. The purpose of this study was to compare clinical characteristics, exercise test responses, and physical activity patterns in Q1 versus Q2 in apparently healthy individuals. METHODS: A total of 4384 subjects referred for clinical treadmill testing from 1986 to 2006 were followed for a mean +/- SD period of 8.7 +/- 5.3 yr. All subjects had normal exercise ECG responses and no history of cardiovascular disease. Subjects were classified into quintiles of exercise capacity measured in METs. Clinical characteristics, physical activity patterns, and treadmill test results were compared between the first two quintiles (Q1: METs <5.9 (n = 693); Q2: METs 6.0-7.9 (n = 842)). RESULTS: Small differences in age (64 +/- 11 vs 60 +/- 10 yr, P < 0.001), use of antihypertensive medications, prevalence of diabetes (21% vs 16%, P = 0.02), and dyslipidemia (43% vs 49%, P = 0.04) were observed between Q1 and Q2. When the Cox proportional hazards model was adjusted for age and other clinical characteristics, the relative risk of mortality remained almost two times greater in Q1 versus Q2 (cardiovascular mortality: HR: 4.01 vs 2.01, P < 0.001; reference group: fittest subjects (Q5)). In a subset of 802 subjects, recent recreational physical activity was significantly lower in Q1 versus Q2. CONCLUSIONS: Reduced physical activity patterns rather than differences in clinical characteristics contribute to the striking difference in mortality rates between the least-fit and the next-least-fit quintile of fitness in healthy individuals.
Sandra Mandic; Jonathan N Myers; Ricardo B Oliveira; Joshua P Abella; Victor F Froelicher
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Medicine and science in sports and exercise     Volume:  41     ISSN:  1530-0315     ISO Abbreviation:  Med Sci Sports Exerc     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-20     Completed Date:  2009-11-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8005433     Medline TA:  Med Sci Sports Exerc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1573-9     Citation Subset:  IM; S    
Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
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MeSH Terms
California / epidemiology
Exercise Test
Health Status*
Middle Aged
Mortality / trends*
Physical Fitness*
Proportional Hazards Models

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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