Cardiorespiratory Fitness as a Predictor of Non-Cardiovascular Disease and Non-Cancer Mortality in Men

Joshua R Sparks; Xuewen Wang; Carl J Lavie; Jiajia Zhang; Xuemei Sui

doi:10.1016/j.mayocp.2023.11.024

Cardiorespiratory Fitness as a Predictor of Non-Cardiovascular Disease and Non-Cancer Mortality in Men

Mayo Clin Proc. 2024 Apr 24:S0025-6196(23)00599-2. doi: 10.1016/j.mayocp.2023.11.024. Online ahead of print.

Authors

Joshua R Sparks¹, Xuewen Wang², Carl J Lavie³, Jiajia Zhang⁴, Xuemei Sui⁵

Affiliations

¹ Department of Exercise Science, Norman J. Arnold School of Public Health, University of South Carolina, Columbia; Reproductive Endocrinology and Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge.
² Department of Exercise Science, Norman J. Arnold School of Public Health, University of South Carolina, Columbia.
³ Department of Cardiovascular Disease, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, LA.
⁴ Department of Epidemiology and Biostatistics, Norman J. Arnold School of Public Health, University of South Carolina, Columbia.
⁵ Department of Exercise Science, Norman J. Arnold School of Public Health, University of South Carolina, Columbia. Electronic address: msui@mailbox.sc.edu.

PMID: 38661595
DOI: 10.1016/j.mayocp.2023.11.024

Abstract

Objective: To evaluate the association of 5 major cause-specific non-cardiovascular disease (CVD) and non-cancer deaths with cardiorespiratory fitness (CRF).

Methods: Patients were 36,645 men (43.3±9.3 years) free of known CVD and cancer at baseline who completed a maximal treadmill graded exercise test during a preventive examination at the Cooper Clinic (Dallas, Texas) between 1971 and 2003. CRF was quantified as maximal treadmill exercise test duration and grouped as low (referent), moderate, and high. Cause-specific non-CVD non-cancer deaths were (1) diabetes or kidney disease, (2) chronic respiratory disease, (3) acute respiratory and infectious disease, (4) injuries, and (5) other non-CVD non-cancer deaths.

Results: A total of 694 non-CVD non-cancer deaths occurred during an average of 17 years of follow-up. After adjustment for covariates, hazard ratios (95% confidence intervals) for moderate and high CRF, respectively, were 0.57 (0.47 to 0.69) and 0.43 (0.34 to 0.54) for overall non-CVD non-cancer deaths (P<.0001); 0.39 (0.28 to 0.54) and 0.17 (0.10 to 0.28) for diabetes or kidney disease (P<.001); 0.36 (0.22 to 0.59) and 0.09 (0.04 to 0.20) for chronic respiratory diseases (P<.001 for all); 0.74 (0.47 to 1.16) and 0.34 (0.19 to 0.61) for acute respiratory and infectious diseases (P<.01 for both); and 0.48 (0.35 to 0.66) and 0.38 (0.26 to 0.55) for any other non-CVD non-cancer deaths (P<.0001 for both).

Conclusion: Higher levels of CRF were significantly associated with lower risk of mortality from the 5 major non-CVD non-cancer causes. These results suggest that improvement in CRF may reduce non-CVD non-cancer deaths, which account for a significant proportion of adult mortality.