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Cited by 412Cardiovascular and exercise physiologyPhysical Activity and HealthCardiovascular Effects of Exercise

Exercise Capacity and Mortality in Black and White Men

Kokkinos, Peter, Myers, Jonathan, Kokkinos, John Peter, Pittaras, Andreas, Narayan, Puneet, Manolis, Athanasios, Karasik, Pamela, Greenberg, Michael +2 more·2008·Circulation
DOI 10.1161/circulationaha.107.734764
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Abstract

Background— Exercise capacity is inversely related to mortality risk in healthy individuals and those with cardiovascular diseases. This evidence is based largely on white populations, with little information available for blacks. Methods and Results— We assessed the association between exercise capacity and mortality in black (n=6749; age, 58±11 years) and white (n=8911; age, 60±11 years) male veterans with and without cardiovascular disease who successfully completed a treadmill exercise test at the Veterans Affairs Medical Centers in Washington, DC, and Palo Alto, Calif. Fitness categories were based on peak metabolic equivalents (METs) achieved. Subjects were followed up for all-cause mortality for 7.5±5.3 years. Among clinical and exercise test variables, exercise capacity was the strongest predictor of risk for mortality. The adjusted risk was reduced by 13% for every 1-MET increase in exercise capacity (hazard ratio, 0.87; 95% confidence interval, 0.86 to 0.88; P <0.001). Compared with those who achieved <5 METs, the mortality risk was ≈50% lower for those with an exercise capacity of 7.1 to 10 METs (hazard ratio, 0.51; 95% confidence interval, 0.47 to 0.56; P <0.001) and 70% lower for those achieving >10 METs (hazard ratio, 0.31; 95% confidence interval, 0.26 to 0.36; P <0.001). The findings were similar for those with and without cardiovascular disease and for both races. Conclusions— Exercise capacity is a strong predictor of all-cause mortality in blacks and whites. The relationship was inverse and graded, with a similar impact on mortality outcomes for both blacks and whites.

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Crossref · 10.1161/circulationaha.107.734764

Cites

35 of 35 references verified0 citation errors · 0 not checkable

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  • Measures of exercise capacity outperform echocardiography in prognostic assessment.

    “Measures of exercise capacity outperform echocardiography in prognostic assessment. 36”

    From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [36]

    The Discussion (page not provided) says exercise capacity has prognostic power for mortality in Black and White men. The Exercise Assessments section describes treadmill testing, but the paper does not compare its prognostic performance with echocardiography. That comparison is unsupported. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Unfit individuals who improved their fitness status with serial testing had a 35% lower mortality risk compared with those who remained unfit.

    “Unfit individuals who improved their fitness status with serial testing had a 35% lower mortality risk compared with those who remained unfit (279).”

    From Lack of Exercise Is a Major Cause of Chronic Diseases (2012) · cites this paper as [279]

  • Each 1-MET decrease in maximal aerobic exercise capacity increases the adjusted hazard ratio for death by 12%.

    “Each 1-MET decrease in maximal aerobic exercise capacity increases the adjusted hazard ratio for death by 12% (279).”

    From Lack of Exercise Is a Major Cause of Chronic Diseases (2012) · cites this paper as [279]

  • Using 4 MET maximal aerobic exercise capacity as reference 1.0, mortality risk was 38% lower for those achieving 5.1 to 6.0 METs and declined progressively to 61% lower for those achieving more than 9 METs, regardless of age.

    “Using those individuals with 4 MET maximal aerobic exercise capacity as a reference value of 1.0, the mortality risk was 38% lower for those who achieved 5.1 to 6.0 METs, mortality risk declining progressively to 61% for those who achieved >9 METs, regardless of age.”

    From Lack of Exercise Is a Major Cause of Chronic Diseases (2012) · cites this paper as [279]

  • Previous studies of cardiorespiratory fitness and mortality have not specifically identified or analyzed patients with extremely high cardiorespiratory fitness.

    “Previous studies4,5,7 of CRF and mortality have not specifically identified or analyzed patients with extremely high CRF, and it remains unclear whether there is an upper limit of CRF above which no further benefit or even harm is seen.”

    From Association of Cardiorespiratory Fitness with Long-term Mortality Among Adults Undergoing Exercise Treadmill Testing (2018) · cites this paper as [7]

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Cites

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Research works printed but not linked: 1

  1. Myers J. Beyond ST segment displacement: Newer diagnostic and prog- nostic markers for exercise test. Am J Med Sports. 2003;5:332-336.

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Authors
Kokkinos, P., Myers, J., Kokkinos, J. P., Pittaras, A., Narayan, P., Manolis, A., Karasik, P., Greenberg, M., Papademetriou, V., & Singh, S.
Affiliations
  • From the Veterans Affairs Medical Center, Cardiology Department (P. Kokkinos, J.P.K., A.P., P.N., A.M., P. Karasik, M.G., V.P.) and Georgetown University School of Medicine (P. Kokkinos, S.S.), Washington, DC, and Veterans Affairs Palo Alto Health Care System, Cardiology Division, and Stanford University, Stanford, Calif (J.M.).
  • Georgetown University (US)
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2008-02-05
Volume
117
Issue
5
Pages
614-622
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/circulationaha.107.734764
OpenAlex
W2130661160
Cited by
412
References
35
Citations by year
2026: 5 · 2025: 12 · 2024: 14 · 2023: 15 · 2022: 16 · 2021: 24 · 2020: 21 · 2019: 23 · 2018: 22 · 2017: 31 · 2016: 24 · 2015: 24 · 2014: 31 · 2013: 39 · 2012: 27
FWCI
79.43
Type
journal article
Language
en
Open access
closed
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Funders
U.S. Department of Veterans Affairs (IK6 RX002477)
Topics
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
Keywords
exercise capacity, all-cause mortality, racial differences, Black men, white men, cardiovascular disease, treadmill exercise testing, peak metabolic equivalents, veterans, mortality prediction
MeSH terms
Aged, Black or African American, Exercise Test, Follow-Up Studies, Humans, Male, Middle Aged, Mortality, Physical Fitness, United States, Exercise, Exercise Tolerance, Black People, White People, Racial Groups

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