A simple nonexercise model of cardiorespiratory fitness predicts long-term mortality
Abstract
PURPOSE: Cardiorespiratory fitness (CRF) is a strong predictor of future health, but measurements of CRF are time consuming and involve costly test procedures. We assessed whether a simple, non-exercise-based test of CRF predicted long-term all-cause and cardiovascular disease (CVD) mortality. METHODS: In this prospective cohort study, we used a previously published nonexercise test to estimate CRF in healthy men (n = 18,348) and women (n = 18,764) from the first HUNT study (1984-1986) in Norway. We used Cox regression to obtain HR for mortality during a mean follow-up of 24 yr. Assessment of model validity was performed by standard procedures of discrimination and calibration. RESULTS: CRF was inversely associated with all-cause and CVD mortality in men and women below 60 yr of age at baseline, after adjustment for confounders. For each MET-higher CRF (MET, approximately 3.5 mL·kg·min), HR for CVD mortality was 21% lower in both men (95% confidence interval (CI), 17%-26%) and women (95% CI, 12%-29%). HR for all-cause mortality was 15% (95% CI, 12%-17%) lower in men and 8% (95% CI, 3%-3%) lower in women for each MET-higher CRF. The ability of the model to discriminate mortality risk among participants below 60 yr was better for CRF (area under the curve (AUC), 0.70-0.77) compared with that for each variable that constituted the model (AUC, 0.55-0.63) and an aggregated sum of z-scores for each variable (AUC, 0.61-0.65). Comparison of observed and predicted risk indicated good model calibration. CONCLUSIONS: This method of assessing CRF is feasible and practically useful in primary care for identification of apparently healthy individuals at increased risk of premature CVD disease and all-cause mortality.
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In the present study, questionnaires seem to be suitable tools to assess moderate and high intensities of physical activity.
“Thus, in the present study, questionnaires seem to be suitable tools to assess moderate and high intensities of physical activity.”
From Effect of exercise training for five years on all cause mortality in older adults—the Generation 100 study: randomised controlled trial (2020) · cites this paper as [23]
Observational studies have shown that even a 1 mL/kg/min increase in peak oxygen uptake has been associated with a substantial impact on survival and incidence of fatal and non-fatal coronary heart disease.
“Observational studies have shown that even a 1 mL/kg/min increase in peak oxygen uptake has been associated with a substantial impact on survival23 38 39 40 and incidence of fatal and non-fatal coronary heart disease.41”
From Effect of exercise training for five years on all cause mortality in older adults—the Generation 100 study: randomised controlled trial (2020) · cites this paper as [23]
In numerous studies the present physical activity questions have shown sensitivity to predict current and future cardiovascular health.
“Importantly, in numerous studies5 23 the present physical activity questions have shown sensitivity to predict current and future cardiovascular health.”
From Effect of exercise training for five years on all cause mortality in older adults—the Generation 100 study: randomised controlled trial (2020) · cites this paper as [23]
There is a 21% lower risk of mortality for every 1-MET increase in cardiorespiratory fitness in both sexes.
“Nes et al. [47] reported a 21% lower risk of mortality for every 1-MET increase in CRF in both sexes”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [47]
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Self-citation
- Authors
- NES, B. M., VATTEN, L. J., NAUMAN, J., JANSZKY, I., & WISLØFF, U.
- Affiliations
- Norwegian University of Science and Technology (NO)
- Venue
- Medicine & Science in Sports & Exercise
- Published
- 2014-06
- Volume
- 46
- Issue
- 6
- Pages
- 1159-1165
- ISSN
- 0195-9131 (ISSN-L)
- OpenAlex
- W2048356582
- Cited by
- 154
- References
- 37
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 16 · 2023: 10 · 2022: 18 · 2021: 13 · 2020: 21 · 2019: 19 · 2018: 10 · 2017: 8 · 2016: 10 · 2015: 8 · 2014: 2
- FWCI
- 20.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medicine & Science in Sports & Exercise (publishedVersion)
- PubMed (publishedVersion)
- 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
- cardiorespiratory fitness, all-cause mortality, cardiovascular mortality, mortality prediction, primary care, healthy adults, HUNT study, risk discrimination and calibration
- MeSH terms
- Adult, Age Factors, Cardiovascular Diseases, Cardiovascular Physiological Phenomena, Female, Humans, Life Style, Male, Middle Aged, Mortality, Physical Examination, Physical Fitness, Prospective Studies, Surveys and Questionnaires, Respiration, Risk Assessment
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