INFLUENCES OF CARDIORESPIRATORY FITNESS LEVELS AND OTHER PREDICTORS ON CARDIOVASCULAR-DISEASE MORTALITY IN MEN

Purpose: This investigation quantifies the relation between cardioresp iratory fitness revels and cardiovascular disease (CVD) mortality with in strata of other CVD predictors. Methods: participants included 25,3 41 male Cooper Clinic patients who underwent a maximal graded exercise test. CVD death rates were determined for low (least fit one-fifth), moderate (next two-fifths), and high (top two-fifths) cardiorespirator y fitness categories by strata of smoking habit, blood cholesterol lev el, resting blood pressure, and health status. There were 226 cardiova scular deaths during 211,996 man-years of follow-up. Results: For indi viduals with none of the major CVD predictors (smoking, elevated resti ng systolic blood pressure, elevated blood cholesterol), there was a s trong inverse relation (P = 0.001) between fitness level and CVD morta lity. An inverse relation between CVD mortality and fitness level was seen within strata of cholesterol revels and hearth status. No evidenc e of a trend (P = 0.60) for decreased mortality was seen across fitnes s levels for individuals with elevated systolic blood pressure; howeve r, a strong inverse gradient (P < 0.001) was seen across fitness level s for individuals with normal systolic blood pressure. There was a ten dency for association between high revels of fitness and decreased CVD mortality in smokers compared with low and moderately fit smokers (P < 0.076). There was no significant association between lever of fitnes s and CVD mortality for individuals with multiple (two or more) predic tors (P = 0.325). Approximately 20% of the 226 CVD deaths in the popul ation studied were attributed to low fitness level. Conclusions: Moder ate and high levels of cardiorespiratory fitness seem to provide some protection from CVD mortality, even in the presence of well establishe d CVD predictors.