Midlife Cardiorespiratory Fitness and the Long-Term Risk of Mortality 46 Years of Follow-Up
Midlife Cardiorespiratory Fitness and the Long-Term Risk of Mortality 46 Years of Follow-Up
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DOI：
10.1016/j.jacc.2018.06.045
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发表时间：
2018-08-28
影响因子：
24
通讯作者：
Jensen, Magnus T.
中科院分区：
文献类型：
--
作者：
Clausen, Johan S. R.;Marott, Jacob L.;Jensen, Magnus T.
高心肺适能（CRF）水平被推荐用于促进健康老龄化。然而，CRF和非常长期预后之间的关联尚不清楚，并且反向因果关系可能在随访时间较短的研究中产生偏倚结果。纳入并分为4个年龄调整的最大耗氧量（VO（2）max）类别：低于正常下限（最低5%）;正常下限（45%）;正常上限（45%）;和高于正常上限（最高5%）。采用自行车测功计测定VO（2）max。多变量限制平均生存时间模型进行全因和心血管死亡率使用丹麦国家register.RESULTS一个总的5,107名男子，平均年龄为48.8 +/- 5.4岁，包括在研究中。在46年的随访中，4，700名（92%）男性死亡; 2，149名（42.1%）男性死于CVD。与低于正常CRF下限相比，低正常CRF与2.1年相关（95%置信区间[CI]：0.7 - 3.4; p = 0.002），2.9年时为高正常值（95% CI：1.5至4.2; p < 0.001），高于正常上限，平均预期寿命延长4.9年（95% CI：3.1至6.7; p < 0.001）。VO（2）max每增加一个单位与寿命延长45天相关（95%CI：30 ~ 61; p < 0.001）。心血管死亡率的估计值与全因死亡率相似。结果基本上没有变化时，排除个人谁在第一个10年内死亡的后续行动，这表明一个最小的作用，反向causation.CONCLUSIONS CRF显着相关的寿命超过40年的过程中，中年，就业男性无心血管疾病。中年偏高的慢性肾衰竭的好处可以延续到生命的后期。(C)2018年由美国心脏病学会基金会。
BACKGROUND A high cardiorespiratory fitness (CRF) level is recommended to promote healthy aging. However, the association between CRF and very-long-term prognosis is unclear, and reverse causation may bias results in studies with shorter follow-up.OBJECTIVES This study investigated the association between CRF and mortality in middle-aged, employed men free of cardiovascular disease (CVD).METHODS Participants from the Copenhagen Male Study, established in 1970 to 1971, were included and stratified into 4 age-adjusted maximal oxygen consumption (VO(2)max) categories: below the lower limit of normal (lowest 5%); low normal (45%); high normal (45%); and above the upper limit of normal (top 5%). VO(2)max was estimated by using a bicycle ergometer. Multivariable restricted mean survival time models were performed for all-cause and cardiovascular mortality using Danish national registers.RESULTS A total of 5,107 men with a mean age of 48.8 +/- 5.4 years were included in the study. During the 46 years of follow-up, 4,700 (92%) men died; 2,149 (42.1%) of the men died of CVD. Compared with below the lower limit of normal CRF, low normal CRF was associated with 2.1 years (95% confidence interval [CI]: 0.7 to 3.4; p = 0.002), high normal with 2.9 years (95% CI: 1.5 to 4.2; p < 0.001), and above upper limit of normal with 4.9 years (95% CI: 3.1 to 6.7; p < 0.001) longer mean life expectancy. Each unit increase in VO(2)max was associated with a 45-day (95% CI: 30 to 61; p < 0.001) increase in longevity. Estimates for cardiovascular mortality were similar to all-cause mortality. Results were essentially unchanged when excluding individuals who died within the first 10 years of follow-up, suggesting a minimal role of reverse causation.CONCLUSIONS CRF was significantly related to longevity over the course of 4 decades in middle-aged, employed men free of CVD. The benefits of higher midlife CRF extend well into the later part of life. (C) 2018 by the American College of Cardiology Foundation.