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Published on: April 19, 2019
Cardiorespiratory fitness and classification of risk of cardiovascular disease mortality
Sachin Gupta1, Anand Rohatgi, Colby R Ayers
1University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9047, USA.
Circulation
|March 23, 2011
Summary
Cardiorespiratory fitness significantly enhances cardiovascular disease (CVD) risk prediction. Adding fitness to traditional risk factors improves the classification of both short-term and long-term CVD mortality risk.
Area of Science:
- Preventive Cardiology
- Public Health
- Exercise Physiology
Background:
- Cardiorespiratory fitness is linked to cardiovascular disease (CVD) mortality.
- The added value of fitness in risk classification with traditional factors is not well-defined.
Purpose of the Study:
- To determine if cardiorespiratory fitness improves CVD mortality risk classification beyond traditional risk factors.
- To assess the impact of fitness on short-term (10-year) and long-term (25-year) CVD risk prediction.
Main Methods:
- Utilized data from 66,371 subjects in the Cooper Center Longitudinal Study (1970-2006).
- Measured cardiorespiratory fitness using the Balke protocol.
- Employed Cox proportional hazards models, calculating net reclassification improvement and integrated discrimination improvement with and without fitness data.
Main Results:
- In men, adding fitness reclassified 10.7% of individuals, showing significant improvement in 10-year (NRI=0.121) and 25-year (NRI=0.041) CVD mortality risk.
- Integrated discrimination improvement was 0.010 at 10 years (29% relative improvement).
- Similar significant improvements in risk classification were observed for women at 25 years.
Conclusions:
- A single cardiorespiratory fitness measurement substantially enhances CVD mortality risk stratification.
- Fitness improves the classification of both short-term and long-term cardiovascular risk when combined with traditional risk factors.
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