Changes in physical fitness and all-cause mortality. A prospective study of healthy and unhealthy men.
Changes in physical fitness and all-cause mortality. A prospective study of healthy and unhealthy men.
复制标题
DOI：
10.1001/jama.1995.03520380029031
复制
发表时间：
1995-04
期刊：
影响因子：
--
通讯作者：
S. Blair;H. Kohl;C. Barlow;R. Paffenbarger;L. Gibbons;C. Macera
中科院分区：
文献类型：
--
作者：
S. Blair;H. Kohl;C. Barlow;R. Paffenbarger;L. Gibbons;C. Macera
目的评价男性体质变化与死亡风险之间的关系。设计：前瞻性研究，两次临床检查（检查之间的平均间隔，4.9年），以评估身体健康的变化或缺乏变化与后续检查后随访期间死亡风险的相关性（后续检查的平均随访时间，5.1年）。单位：预防医学门诊。研究对象参与者是9777名男性，他们接受了两次预防性体检，每次体检都包括通过最大运动试验评估体能和评估健康状况。主要观察指标：全因死亡（n = 223）和心血管疾病死亡（n = 87）。结果：在两项检查均不合格的男性中观察到最高的年龄调整全因死亡率（122.0/10，000人年）;在两项检查均身体健康的男性中死亡率最低（39.6/10，000人年）。在第一次和随后的检查之间从不适合改善到适合的男性的年龄调整死亡率为67.7/10，000人年。这是一个死亡风险降低44%（95%置信区间，25%至59%）相对于男性谁仍然不适合在两个检查。在调整了年龄、健康状况和其他过早死亡的危险因素后，健康状况的改善与较低的死亡率相关。两次检查之间的最大跑步机时间每增加一分钟，死亡风险相应降低7.9%（P = 0.001）。当按健康状况和心血管疾病死亡率对该组进行分层时，也看到了类似的结果。结论：在随访期间，保持或改善适当身体健康的男性比持续不健康的男性死于各种原因和心血管疾病的可能性更小。医生应该鼓励不健康的男性通过开始体育活动来改善他们的健康状况。
OBJECTIVE To evaluate the relationship between changes in physical fitness and risk of mortality in men. DESIGN Prospective study, with two clinical examinations (mean interval between examinations, 4.9 years) to assess change or lack of change in physical fitness as associated with risk of mortality during follow-up after the subsequent examination (mean follow-up from subsequent examination, 5.1 years). SETTING Preventive medicine clinic. STUDY PARTICIPANTS Participants were 9777 men given two preventive medical examinations, each of which included assessment of physical fitness by maximal exercise tests and evaluation of health status. MAIN OUTCOME MEASURES All cause (n = 223) and cardiovascular disease (n = 87) mortality. RESULTS The highest age-adjusted all-cause death rate was observed in men who were unfit at both examinations (122.0/10,000 man-years); the lowest death rate was in men who were physically fit at both examinations (39.6/10,000 man-years). Men who improved from unfit to fit between the first and subsequent examinations had an age-adjusted death rate of 67.7/10,000 man-years. This is a reduction in mortality risk of 44% (95% confidence interval, 25% to 59%) relative to men who remained unfit at both examinations. Improvement in fitness was associated with lower death rates after adjusting for age, health status, and other risk factors of premature mortality. For each minute increase in maximal treadmill time between examinations, there was a corresponding 7.9% (P = .001) decrease in risk of mortality. Similar results were seen when the group was stratified by health status, and for cardiovascular disease mortality. CONCLUSIONS Men who maintained or improved adequate physical fitness were less likely to die from all causes and from cardiovascular disease during follow-up than persistently unfit men. Physicians should encourage unfit men to improve their fitness by starting a physical activity program.