| A graded association of exercise capacity and all-cause mortality in males with high-normal blood pressure. | |
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MedLine Citation:
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PMID: 19919397 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article |
Journal Detail:
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Title: Blood pressure Volume: 18 ISSN: 1651-1999 ISO Abbreviation: Blood Press. Publication Date: 2009 |
Date Detail:
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Created Date: 2009-11-20 Completed Date: 2010-01-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9301454 Medline TA: Blood Press Country: England |
Other Details:
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Languages: eng Pagination: 261-7 Citation Subset: IM |
Affiliation:
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Veterans Affairs Medical Center, Washington, DC 20422, USA. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Blood Pressure / physiology* Exercise Test Exercise Tolerance / physiology* Humans Hypertension / mortality*, physiopathology Male Middle Aged Mortality Physical Fitness Predictive Value of Tests Retrospective Studies Risk Factors Survival Rate |
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