Cited by 464Physical Activity and HealthCardiovascular and exercise physiologyCardiovascular Effects of Exercise

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Changes in physical fitness and changes in mortality

Erikssen, Gunnar, Liestøl, Knut, Bjørnholt, Jørgen, Thaulow, Erok, Sandvik, Leiv, Erikssen, Jan·1998·The Lancet

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Abstract

Background Point estimates of physical fitness give important information on the risk of death in healthy people, but there is little information available on effects of sequential changes in physical fitness on mortality. We studied this latter aspect in healthy middle-aged men over a total follow-up period of 22 years. Methods 2014 healthy men aged 40-60 years had a bicycle exercise test and clinical examination, and completed a questionnaire in 1972-75 (survey 1). This was repeated for 1756 (91%) of 1932 men still alive by Dec 31, 1982 (survey 2). The exercise scores were adjusted for age. The change in exercise scores between surveys was divided into quartiles (Q1=least fit, Q4=fittest). An adjusted Cox's proportional hazards model was used to study the association between changes in physical fitness and mortality, with the Q1 men used as controls. Findings By Dec 31, 1994, 238 (17%) of the 1428 men had died, 120 from cardiovascular causes. There were 37 deaths in the Q4 group (19 cardiovascular); their relative risks of death were 0.45 (95% CI 0.29-0.69) for any cause and 0.47 (0.26-0.86) for cardiovascular causes. There was a graded, inverse relation between changes in physical fitness and mortality irrespective of physical fitness status at survey 1. Interpretation Change in physical fitness in healthy middle-aged men is a strong predictor of mortality. Even small improvements in physical fitness are associated with a significantly lowered risk of death. If confirmed, these findings should be used to influence public health policy.

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Authors: Erikssen, G., Liestøl, K., Bjørnholt, J., Thaulow, E., Sandvik, L., & Erikssen, J.
Affiliations: Akershus University Hospital (NO)
University of Oslo (NO)
Oslo University Hospital (NO)
ORCID: Erikssen, Gunnar
Liestøl, Knut
Bjørnholt, Jørgen
Sandvik, Leiv
Venue: The Lancet
Publisher: Elsevier BV
Published: 1998-09
Volume: 352
Issue: 9130
Pages: 759-762
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(98)02268-5
OpenAlex: W2038621442
Cited by: 464
References: 25
Citations by year: 2026: 7 · 2025: 9 · 2024: 9 · 2023: 13 · 2022: 17 · 2021: 16 · 2020: 15 · 2019: 14 · 2018: 20 · 2017: 21 · 2016: 16 · 2015: 17 · 2014: 12 · 2013: 29 · 2012: 22
FWCI: 8.81
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
Keywords: physical fitness, mortality, cardiovascular mortality, middle-aged men, exercise capacity, bicycle exercise test, fitness change, mortality prediction, public health policy
MeSH terms: Adult, Cardiovascular Diseases, Cause of Death, Exercise Test, Follow-Up Studies, Humans, Male, Middle Aged, Mortality, Neoplasms, Physical Fitness, Risk, Proportional Hazards Models

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