Body Mass Index, Exercise Capacity, and Mortality Risk in Male Veterans With Hypertension
Body Mass Index, Exercise Capacity, and Mortality Risk in Male Veterans With Hypertension
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DOI：
10.1038/ajh.2011.242
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发表时间：
2012-04-01
影响因子：
3.2
通讯作者：
Kokkinos, Peter
中科院分区：
文献类型：
--
作者：
Faselis, Charles;Doumas, Michael;Kokkinos, Peter
超重和肥胖与慢性病和死亡风险增加有关。运动能力与死亡风险呈负相关。然而，很少有人知道的健身，肥胖，高血压患者的死亡风险之间的相互作用。因此，我们评估了运动能力、肥胖和高血压男性全因死亡率之间的相互作用。63.3+/- 10.5年）在退伍军人事务医疗中心，华盛顿，DC。我们根据体重指数（BMI）定义了三种体重类别：正常体重（BMI = 30）;根据达到的峰值代谢当量（MET）定义了三种健康类别：低健康（7.5 MET）。运动能力和死亡风险之间的关联是强的、反向的和分级的。运动能力每增加1-MET，正常体重的校正风险为20%，超重为12%，肥胖为25%（P < 0.001）。与正常体重但不健康的个体相比，超重/高健康个体的死亡风险降低60%，肥胖/高健康个体的死亡风险降低78%（P < 0.001）。与正常体重但不健康的人相比，超重和肥胖但健康的人的风险显著降低。这些发现表明，在老年高血压男性中，无论标准BMI类别如何，健康可能比不健康和正常体重更健康。
BACKGROUNDOverweight and obesity are associated with increased risk of chronic diseases and mortality. Exercise capacity is inversely associated with mortality risk. However, little is known on the interaction between fitness, fatness, and mortality risk in hypertensive individuals. Thus, we assessed the interaction between exercise capacity, fatness, and all-cause mortality in hypertensive males.METHODSA graded exercise test was performed in 4,183 hypertensive veterans (mean age +/- s.d.; 63.3 +/- 10.5 years) at the Veterans Affairs Medical Center, Washington, DC. We defined three body weight categories based on body mass index (BMI): normal weight (BMI = 30); and three fitness categories based on peak metabolic equivalents (METs) achieved: low-fit (7.5 METs).RESULTSDuring a median follow-up period of 7.2 years, there were 1,000 deaths. The association between exercise capacity and mortality risk was strong, inverse, and graded. For each 1-MET increase in exercise capacity the adjusted risk was 20% for normal weight, 12% for overweight, and 25% for obese (P < 0.001). When compared to normal weight but unfit individuals, mortality risks were 60% lower in the overweight/high-fit and 78% lower in the obese/high-fit individuals (P < 0.001).CONCLUSIONSIncreased exercise capacity is associated with lower mortality risk in hypertensive males regardless of BMI. The risk for overweight and obese but fit individuals was significantly lower when compared to normal weight but unfit. These findings suggest that in older hypertensive men, it may be healthier to be fit regardless of standard BMI category than unfit and normal weight.