| Characterizing differences in mortality at the low end of the fitness spectrum. | |
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MedLine Citation:
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PMID: 19568203 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Sandra Mandic; Jonathan N Myers; Ricardo B Oliveira; Joshua P Abella; Victor F Froelicher |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 2009-07-20 Completed Date: 2009-11-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8005433 Medline TA: Med Sci Sports Exerc Country: United States |
Other Details:
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Languages: eng Pagination: 1573-9 Citation Subset: IM; S |
Affiliation:
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Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA. sandra.mandic@otago.ac.nz |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged California / epidemiology Exercise Test Female Health Status* Humans Male Middle Aged Mortality / trends* Physical Fitness* Prognosis Proportional Hazards Models Questionnaires |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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