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A graded association of exercise capacity and all-cause mortality in males with high-normal blood pressure.
MedLine Citation:
PMID:  19746293     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Introduction. Information regarding the effect of exercise capacity on mortality risk in individuals with high-normal blood pressure is severely limited. Thus, we evaluated the association of exercise capacity and all-cause mortality in individuals with high-normal blood pressure. Methods. Exercise test was performed in 1727 males with high-normal blood pressure at two Veteran sites (Washington, DC, and Palo Alto, CA). Fitness status was assessed in metabolic equivalents (METs) at exercise peak. All-cause mortality was recorded for a mean follow-up period of 9.8+/-6.0 years. Results. Exercise capacity was inversely associated with all-cause mortality, and the association was independent of traditional cardiovascular risk factors. For each 1 MET increase in exercise capacity, the adjusted mortality risk was reduced by 13%, underscoring the strong predictive value of exercise capacity that was confirmed by ROC analysis. Data analysis according to fitness levels revealed a threshold level of 4 METs, over which the mortality risk was progressively reduced by 30% (hazard ratio=0.70; CI 0.51-0.95) for those who achieved 4.1-6.0 METs and 61% (hazard ratio=0.39; CI 0.26-0.57) for those who achieved 8.1-10 METs. No additional reductions in risk were noted until the MET level achieved exceeded 12 METs. Conclusions. We observed a strong, inverse, graded and independent association between exercise capacity and all-cause mortality in individuals with high-normal blood pressure. Our findings indicate that a shift of the fitness curve to the right is associated with significant survival benefits, and even slight differences in fitness levels are associated with substantial reductions in mortality risk.
Authors:
Peter Kokkinos; Michael Doumas; Jonathan Myers; Charles Faselis; Athanasios Manolis; Andreas Pittaras; John Peter Kokkinos; Vasilios Papademetriou; Steven Singh; Ross D Fletcher
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2009-9-10
Journal Detail:
Title:  Blood pressure     Volume:  -     ISSN:  1651-1999     ISO Abbreviation:  Blood Press.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-9-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9301454     Medline TA:  Blood Press     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-7     Citation Subset:  -    
Affiliation:
Veterans Affairs Medical Center, 50 Irving Street NW, Washington, DC, USA.
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