Journal
PREVENTIVE MEDICINE
Volume 127, Issue -, Pages -Publisher
ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.ypmed.2019.105799
Keywords
Cardiovascular disease; Cancer; Aerobic capacity; VO(2)max; Population; Risk
Funding
- Swedish Research Council for Health, Working Life and Welfare (FORTE) [2018-00384]
- Swedish Heart-Lung Foundation [20180636]
- Swedish Military Forces Research Authority [AF 922 0915]
- Forte [2018-00384] Funding Source: Forte
- Swedish Research Council [2018-00384] Funding Source: Swedish Research Council
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The aim was to investigate sex- and age-specific associations between cardiorespiratory fitness, all-cause and cause-specific mortality, and cardiovascular disease (CVD) morbidity. 266.109 participants (47% women, 18-74 years) free from CVD, participating in occupational health service screenings in 1995-2015 were included. CRF was assessed as estimated maximal oxygen consumption (estVO(2)max) using a submaximal cycle test. Incident cases of first-time CVD event and death from any cause were ascertained through national registers. There were 4244 CVD events and 2750 cases of all-cause mortality during mean 7.6 years follow-up. Male gender, higher age and lower estVO(2)max were associated with higher all-cause mortality and CVD morbidity incidence rates. Risk reductions with increasing estVO(2)max were present in all age-groups of men and women. No obvious levelling off in risk was identified in the total cohort. However, women and older age-groups showed no further reduction in higher aggregated estVO(2)max levels. CVD specific mortality was more associated with estVO(2)max compared to tumor specific mortality. The risk for all-cause mortality and CVD morbidity decreased by 2.3% and 2.6% per increase in 1 ml.min(-) (1).kg(-1) with no significant sex-differences but more pronounced in the three lower estVO(2)max categories for all-cause mortality (9.1%, 3.8% and 3.3%, respectively). High compared to lower levels of estVO(2)max was not related to a significantly elevated mortality or morbidity. In this large cohort study, CVD morbidity and all-cause mortality were inversely related to estVO(2)max in both men and women of all age-groups. Increasing cardiorespiratory fitness is a clear public health priority.
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