PHYSICAL-FITNESS AS A PREDICTOR OF CARDIOVASCULAR MORTALITY IN ASYMPTOMATIC NORTH-AMERICAN MEN - THE LIPID RESEARCH CLINICS MORTALITY FOLLOW-UP-STUDY
PHYSICAL-FITNESS AS A PREDICTOR OF CARDIOVASCULAR MORTALITY IN ASYMPTOMATIC NORTH-AMERICAN MEN - THE LIPID RESEARCH CLINICS MORTALITY FOLLOW-UP-STUDY
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DOI：
10.1056/nejm198811243192104
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发表时间：
1988-11-24
影响因子：
158.5
通讯作者：
SHEPS, DS
中科院分区：
文献类型：
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作者：
EKELUND, LG;HASKELL, WL;SHEPS, DS
关于身体健康与心血管疾病死亡率之间的关系，现有数据有限。我们对4276名年龄在30到69岁之间的男性进行了一项研究，对他们进行了平均8.5年的跟踪调查。基线检查包括常规冠状动脉危险因素评估和平板运动试验。次极量运动（运动试验第2阶段）期间的心率和运动持续时间被用作身体健康的指标。数据不完整的男性（n = 308）或正在使用心血管药物的男性（n = 213）被排除在分析之外。对基线时有心血管疾病临床证据的男性（n = 649）进行了单独分析。在其余的3106名男性中，有45人死于心血管疾病。在调整年龄和心血管危险因素后，较低的身体健康水平与心血管和冠心病死亡风险较高相关。心血管原因死亡的相对危险度为2.7（95%置信区间，1.4至5.1; P = 0.003）对于健康男性，在第2阶段心率每分钟增加35次，（95%置信区间，1.6至5.5; P = 0.0004）对于那些在跑步机上花费的运动时间减少4.4分钟的人。冠心病死亡的相应值分别为3.2（95%置信区间，1.5~6.7; P = 0.003）和2.8（95%置信区间，1.3~6.1; P = 0.007）。我们的结论是，在临床健康的男性中，较低水平的身体健康与冠心病和心血管疾病的死亡风险较高相关，独立于传统的冠状动脉危险因素。
Limited data are available on the relation between physical fitness and mortality from cardiovascular disease. We examined this question in a study of 4276 men, 30 to 69 years of age, whom we followed for an average of 8.5 years. Examination at base line included assessment of conventional coronary risk factors and treadmill exercise testing. The heart rate during submaximal exercise (stage 2 of the exercise test) and the duration of exercise were used as measures of physical fitness. Men with incomplete data (n = 308) or who were using cardiovascular drugs (n = 213) were excluded from the analysis. Men who had clinical evidence of cardiovascular disease at base line (n = 649) were analyzed separately. Forty-five deaths from cardiovascular causes occurred among the remaining 3106 men. A lower level of physical fitness was associated with a higher risk of death from cardiovascular and coronary heart disease, after adjustment for age and cardiovascular risk factors. The relative risk of death from cardiovascular causes was 2.7 (95 percent confidence interval, 1.4 to 5.1; P = 0.003) for healthy men with an increment of 35 beats per minute in the heart rate during stage 2, and 3.0 (95 percent confidence interval, 1.6 to 5.5; P = 0.0004) for those with a decrement of 4.4 minutes in the exercise time spent on the treadmill. The corresponding values for death from coronary heart disease were 3.2 (95 percent confidence interval, 1.5 to 6.7; P = 0.003) and 2.8 (95 percent confidence interval, 1.3 to 6.1; P = 0.007), respectively. We conclude that a lower level of physical fitness is associated with a higher risk of death from coronary heart disease and cardiovascular disease in clinically healthy men, independent of conventional coronary risk factors.