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Cited by 572Physical Activity and HealthCardiovascular and exercise physiologyObesity, Physical Activity, Diet

Long-Term Effects of Changes in Cardiorespiratory Fitness and Body Mass Index on All-Cause and Cardiovascular Disease Mortality in Men: The Aerobics Center Longitudinal Study

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Lee, Duck-chul, Sui, Xuemei, Artero, Enrique G., Lee, I-Min, Church, Timothy S., McAuley, Paul A., Stanford, Fatima C., Kohl, Harold W. +1 more·2011·Circulation
DOI 10.1161/circulationaha.111.038422PMC PMC3238382
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Abstract

Background—: The combined associations of changes in cardiorespiratory fitness and body mass index (BMI) with mortality remain controversial and uncertain. Methods and Results—: We examined the independent and combined associations of changes in fitness and BMI with all-cause and cardiovascular disease (CVD) mortality in 14 345 men (mean age 44 years) with at least 2 medical examinations. Fitness, in metabolic equivalents (METs), was estimated from a maximal treadmill test. BMI was calculated using measured weight and height. Changes in fitness and BMI between the baseline and last examinations over 6.3 years were classified into loss, stable, or gain groups. During 11.4 years of follow-up after the last examination, 914 all-cause and 300 CVD deaths occurred. The hazard ratios (95% confidence intervals) of all-cause and CVD mortality were 0.70 (0.59–0.83) and 0.73 (0.54–0.98) for stable fitness, and 0.61 (0.51–0.73) and 0.58 (0.42–0.80) for fitness gain, respectively, compared with fitness loss in multivariable analyses including BMI change. Every 1-MET improvement was associated with 15% and 19% lower risk of all-cause and CVD mortality, respectively. BMI change was not associated with all-cause or CVD mortality after adjusting for possible confounders and fitness change. In the combined analyses, men who lost fitness had higher all-cause and CVD mortality risks regardless of BMI change. Conclusions—: Maintaining or improving fitness is associated with a lower risk of all-cause and CVD mortality in men. Preventing age-associated fitness loss is important for longevity regardless of BMI change.

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Authors
Lee, D.-C., Sui, X., Artero, E. G., Lee, I.-M., Church, T. S., McAuley, P. A., Stanford, F. C., Kohl, H. W., & Blair, S. N.
Affiliations
Pennington Biomedical Research Center (US)
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2011-12-06
Volume
124
Issue
23
Pages
2483-2490
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/circulationaha.111.038422
PMC
PMC3238382
OpenAlex
W2132526023
Cited by
572
References
48
Citations by year
2026: 20 · 2025: 19 · 2024: 25 · 2023: 26 · 2022: 27 · 2021: 40 · 2020: 40 · 2019: 37 · 2018: 53 · 2017: 52 · 2016: 50 · 2015: 57 · 2014: 46 · 2013: 47 · 2012: 32
FWCI
27.50
Type
journal article
Language
en
Open access
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
  • Scholar Commons (University of South Carolina) (submittedVersion)
Funders
  • National Institute on Aging (R37AG006945, AG06945, R01AG006945)
  • National Heart, Lung, and Blood Institute (HL62508, R01HL062508)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R21DK088195, DK-088195)
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
cardiorespiratory fitness, body mass index, fitness change, all-cause mortality, cardiovascular mortality, men, treadmill exercise testing, metabolic equivalents, fitness loss, obesity, longevity
MeSH terms
Adult, Cardiovascular Diseases, Cardiovascular Physiological Phenomena, Humans, Longitudinal Studies, Lung, Male, Middle Aged, Physical Fitness, Prospective Studies, Risk Factors, Time Factors, Exercise, Body Mass Index, Proportional Hazards Models, Risk Reduction Behavior

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