Moderate to High Levels of Cardiorespiratory Fitness Attenuate the Effects of Triglyceride to High-Density Lipoprotein Cholesterol Ratio on Coronary Heart Disease Mortality in Men

Objective: To examine the prospective relationships among cardiorespiratory fitness (CRF), fasting blood triglyceride to high density lipoprotein cholesterol ratio (TG: HDL-C), and coronary heart disease (CHD) mortality in men. Methods: A total of 40,269 men received a comprehensive baseline clinical examination between January 1, 1978, and December 31, 2010. Their CRF was determined from a maximal treadmill exercise test. Participants were divided into CRF categories of low, moderate, and high fit by age group and by TG: HDL-C quartiles. Hazard ratios for CHD mortality were computed using Cox regression analysis. Results: A total of 556 deaths due to CHD occurred during a mean +/- SD of 16.6 +/- 9.7 years (669,678 man-years) of follow-up. A significant positive trend in adjusted CHD mortality was shown across decreasing CRF categories (P for trend<.01). Adjusted hazard ratios were significantly higher across increasing TG: HDL-C quartiles as well (P for trend<.01). When grouped by CRF category and TG: HDL-C quartile, there was a significant positive trend (P = .04) in CHD mortality across decreasing CRF categories in each TG: HDL-C quartile. Conclusion: Both CRF and TG: HDL-C are significantly associated with CHD mortality in men. The risk of CHD mortality in each TG: HDL-C quartile was significantly attenuated in men with moderate to high CRF compared with men with low CRF. These results suggest that assessment of CRF and TG: HDL-C should be included for routine CHD mortality risk assessment and risk management. (C) 2017 Mayo Foundation for Medical Education and Research