Association of Estimated Cardiorespiratory Fitness in Midlife With Cardiometabolic Outcomes and Mortality
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SUBMITTER: Lee J
PROVIDER: S-EPMC8556623 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectiveTo examine the association between change in nonexercise estimated cardiorespiratory fitness (eCRF) and mortality risk in adult men.Patients and methodsA total of 10,445 men (mean age, 44.6±9.3 years) from the Aerobics Center Longitudinal Study underwent 2 comprehensive medical examinations and peak work rate tests between January 1, 1979, and December 31, 2002, with an average time between measures of 5.7±4.9 years. Participants were observed for 11.6±6.4 years after their second examination until death or December 31, 2003. The eCRF was calculated with the Jackson et al (2012) and Nes et al (2011) published nonexercise estimation equations. Cox proportional hazards models were performed to examine the association between change in eCRF and all-cause and cardiovascular disease (CVD) mortality.ResultsThere were 601 deaths (192 CVD deaths) during the follow-up period. For both eCRF equations, a higher eCRF at baseline was associated with significant reductions in mortality risk from all causes and CVD (P<.001). Change in eCRF by the Jackson equation remained significantly associated with all-cause mortality (P<.001) and CVD mortality (P=.02) after multivariable adjustment. Every 1 metabolic equivalent (3.5 mL·kg-1·min-1) increase in eCRF was associated with a 21% and 22% reduction in mortality risk from all causes or CVD, respectively. No significant associations were observed between change in eCRF by the Nes equation and all-cause (P=.69) or CVD (P=.85) mortality risk after multivariable adjustment.ConclusionThe association between change in nonexercise eCRF and mortality risk may be equation dependent.
| S-EPMC9043563 | biostudies-literature
Project description:BackgroundAssociations of cardiorespiratory fitness in childhood and adulthood with adult cardiometabolic risk factors are poorly understood, not least because of the paucity of studies.ObjectivesWe investigated associations between nonexercise testing cardiorespiratory fitness (NETCRF) in childhood/adulthood and cardiometabolic risk factors in adulthood.MethodsBased on an established algorithm comprising gender, age, body mass index, resting heart rate, and self-reported physical activity at age 10, we computed NETCRF. Risk factors were assessed at age 46 in 5009 participants when NETCRF was again calculated. Linear regression was used to summarize associations between NETCRF in childhood and risk factors in adulthood and, additionally, the relationship between NETCRF in adulthood and risk factors in adulthood after adjusting for childhood NETCRF.ResultsInconsistent associations were observed between childhood NETCRF and adult risk factors. NETCRF in adulthood was associated with blood pressure [-5.8 (-6.7, -4.9)], glycated hemoglobin [-3.41 (-4.06, -2.76)], total cholesterol [-0.16 (-0.24, -0.08)], HDL cholesterol [0.19 (0.16, 0.22)], triglycerides [-0.68 (-0.85, -0.50)], and C-reactive protein [-0.29 (-0.35, -0.22)] in adult males. Similar associations were observed in adult females. Compared to those with low estimated fitness in both childhood and adulthood, participants with low fitness in childhood and high fitness in adulthood had a lower risk of two or more cardiometabolic risk factors (odds ratio: 0.25; 95% confidence interval: 0.19, 0.31).ConclusionAssociations between estimated fitness and risk factors are stronger in adulthood than from childhood to adulthood. Adults with previously sedentary childhoods may still gain benefits from improving their fitness.
| S-EPMC7187251 | biostudies-literature
Project description:ObjectiveTo examine the relationship between estimated maximal cardiorespiratory fitness (CRF) and metabolic syndrome (MetSyn).Patients and methodsWe performed a cross-sectional analysis of 38,659 Aerobics Center Longitudinal Study participants seen between January 1, 1979, and December 31, 2006, to examine CRF levels defined as low (lower 20%), moderate (middle 40%), and high (upper 40%) of age- and sex-specific distributions vs National Cholesterol Education Program-derived MetSyn expressed as a summed z-score continuous variable. We used a general linear model for continuous variables, the χ(2) test for distribution of categorical variables, and multiple linear regression for single and cumulative MetSyn scores adjusted for body mass index, smoking status, alcohol intake, and family history of cardiovascular disease.ResultsWe observed significant inverse trends for MetSyn vs CRF in both sexes (P for trend <.001). The CRF associations vs individual components were as follows: waist circumference-men: β=-.14, r(2)=0.78; women: β=-.04, r(2)=0.71; triglycerides-men: β=-.29, r(2)=0.18; women: β=-.17, r(2)=0.18; high-density lipoprotein cholesterol-men: β=.25, r(2)=0.17; women: β=.08, r(2)=0.19; fasting glucose-men: β=-.09, r(2)=0.09; women: β=.09, r(2)=0.01; systolic blood pressure-men: β=-.09, r(2)=0.09; women: β=-.01, r(2)=0.21; and diastolic blood pressure-men: β=-.07, r(2)=0.12; women: β=-.05, r(2)=0.14. All associations except for systolic blood pressure (both sexes) and glucose (women) are significant (P<.001).ConclusionCardiorespiratory fitness demonstrated a strong inverse relationship with MetSyn in both sexes, with the strongest single associative component being waist circumference.
| S-EPMC3622904 | biostudies-literature
Project description:ObjectiveTo examine the association between estimated cardiorespiratory fitness (eCRF) and incident stroke by black and white race.Participants and methodsA total of 24,162 participants from the REasons for Geographic And Racial Differences in Stroke study (13,232 [54.8%] women; 9543 [39.5%] blacks; mean age, 64.6±9.3 years) without stroke at enrollment between January 15, 2003, and October 30, 2007, were followed for incident stroke through March 31, 2016. Baseline eCRF in maximal metabolic equivalents was determined using nonexercise sex-specific algorithms and further grouped into age- and sex-specific tertiles.ResultsOver a mean of 8.3±3.2 years of follow-up, 945 (3.9%) incident strokes occurred (377 in blacks and 568 in whites). The association between eCRF and stroke risk differed significantly by race (PInteraction<.001). In whites, after adjustment for stroke risk factors and physical functioning score, the hazard ratio of stroke was 0.82 (95% CI, 0.67-1.00) times lower in the middle tertile of eCRF than in the lowest tertile and was 0.54 (95% CI, 0.43-0.69) times lower in the highest tertile of eCRF. The protective effect of higher levels of eCRF on stroke incidence was more pronounced in those 60 years or older among whites. No association between eCRF and stroke risk was observed in blacks.ConclusionEstimated cardiorespiratory fitness measured using nonexercise equations is a useful predictor of stroke in whites. The lack of an overall association between eCRF and stroke risk in blacks suggests that the assessment of eCRF in blacks may not be helpful in primary stroke prevention.
| S-EPMC6154797 | biostudies-literature
Project description:BACKGROUND AND AIMS:While numerous cross-sectional studies have demonstrated an inverse relationship between cardiorespiratory fitness (CRF) and carotid atherosclerosis in middle age, much less is known about the association of midlife CRF with carotid atherosclerosis in later life. METHODS:We studied 1094 participants, free of cardiovascular disease, who completed a maximal exercise test (GXT) for an objective measure of CRF between ages 40 and 59 and carotid ultrasound after the age of 59, with at least five years between studies. Carotid intima media thickness was measured. Assessments were also made regarding the presence of plaque and percent stenosis in four regions: common carotid, bulb, internal carotid and external carotid arteries. Multivariable logistic regression models were constructed to estimate the association of CRF with carotid artery disease. RESULTS:At the time of GXT and carotid scan, participants were aged 50.7?±?5.7 years and 69.3?±?6.4 years, respectively. Almost half of participants had high midlife CRF (48.6%); 41.3% and 10.1% had moderate and low CRF, respectively. Over a mean follow-up period of 18.6?±?8.5 years, the odds of having carotid artery disease in later life in the high CRF group was 0.50 (95% CI: 0.29-0.87) compared with the low CRF group. Each 1 MET increase in CRF was associated with 10% lower odds of having carotid artery disease (OR?=?0.89, 95% CI: 0.80-0.98). CONCLUSIONS:Midlife CRF was inversely associated with carotid artery disease measured almost two decades later. This may represent a mechanistic link between high midlife CRF and reduced risk of stroke in later life.
| S-EPMC6935373 | biostudies-literature
Project description:A study was undertaken to determine whether better cognitive functioning at midlife among more physically fit individuals reflects neuroprotection, by which fitness protects against age-related cognitive decline, or neuroselection, by which children with higher cognitive functioning select more active lifestyles.Children in the Dunedin Longitudinal Study (N?=?1,037) completed the Wechsler Intelligence Scales and the Trail Making, Rey Delayed Recall, and Grooved Pegboard tasks as children and again at midlife (age?=?38 years). Adult cardiorespiratory fitness was assessed using a submaximal exercise test to estimate maximum oxygen consumption adjusted for body weight in milliliters/minute/kilogram. We tested whether more fit individuals had better cognitive functioning than their less fit counterparts (which could be consistent with neuroprotection), and whether better childhood cognitive functioning predisposed to better adult cardiorespiratory fitness (neuroselection). Finally, we examined possible mechanisms of neuroselection.Participants with better cardiorespiratory fitness had higher cognitive test scores at midlife. However, fitness-associated advantages in cognitive functioning were already present in childhood. After accounting for childhood baseline performance on the same cognitive tests, there was no association between cardiorespiratory fitness and midlife cognitive functioning. Socioeconomic and health advantages in childhood and healthier lifestyles during young adulthood explained most of the association between childhood cognitive functioning and adult cardiorespiratory fitness.We found no evidence for a neuroprotective effect of cardiorespiratory fitness as of midlife. Instead, children with better cognitive functioning are selecting healthier lives. Fitness interventions may enhance cognitive functioning. However, observational and experimental studies testing neuroprotective effects of physical fitness should consider confounding by neuroselection.
| S-EPMC4376580 | biostudies-literature
Project description:Cardiorespiratory fitness (CRF) is an independent predictor of morbidity and mortality. In Japan, annual physical exams are mandatory in workplace settings, and most healthcare settings have electronic medical records (EMRs). However, in both settings, CRF is not usually determined, thereby limiting the potential for epidemiological investigations using EMR data. To estimate CRF (mL/kg/min) using variables commonly recorded in EMRs. Participants were 5293 Japanese adults (11.7% women) who completed an annual physical exam at a large gas company in Tokyo, Japan, in 2004. The mean age was 48.3 ± 8.0 years. Estimated CRF (eCRF) was based on age, measured body mass index, resting heart rate, systolic and diastolic blood pressure, and smoking. Measured CRF was determined by a submaximal cycle ergometer graded exercise test. Regression models were used for males and females to calculate Pearson's correlation and regression coefficients. Cross-classification of measured CRF and eCRF was conducted using the lowest quintile, quartile, and tertile as the unfit categories. R's for eCRF were 0.61 (MD 4.41) for men and 0.64 (MD 4.22) for women. The overall accuracy level was reasonable and consistent across models, yet the unfit lower tertile model provided the best overall model when considering the positive predictive value and sensitivity. eCRF may provide a useful method for conducting investigations using data derived from EMRs or datasets devoid of CRF or physical activity measures.
| S-EPMC8656653 | biostudies-literature
Project description:BackgroundEstimated peak oxygen consumption (Vo2peak) is widely used in oncology; however, estimated Vo2peak equations were developed in noncancer settings.ObjectivesThe aim of this study was to evaluate the validity of estimated Vo2peak in women with primary breast cancer and to develop oncology-specific estimated Vo2peak equations.MethodsVo2peak was directly measured (TrueOne 2400, Parvo Medics) during 380 cardiopulmonary exercise tests in women previously treated for breast cancer (mean age: 59 ± 10 years; 3.1 ± 1.2 years post-therapy). The American College of Sports Medicine (ACSM), the Fitness Registry and the Importance of Exercise National Database (FRIEND), and heart failure (HF)-FRIEND equations were used to estimate Vo2peak. New equations were developed using patient and peak (Oncpeak) or submaximal (Oncsub) exercise test characteristics.ResultsThe median differences between measured and estimated Vo2peak were 7.0 mL O2·kg-1·min-1, 3.9 mL O2·kg-1·min-1, and -0.2 mL O2·kg-1·min-1 for ACSM, FRIEND, and HF-FRIEND, respectively. The number of estimated Vo2peak values within ±3.5 mL O2·kg-1·min-1 of the measured values was 70 (18%), 164 (43%), and 306 (81%) for ACSM, FRIEND, and HF-FRIEND, respectively. The Oncpeak and OncSub models included body mass index, age, a history of chemotherapy or radiation, the peak measured heart rate, and the treadmill grade and/or speed. The median differences between measured and estimated Vo2peak were 0.02 mL O2·kg-1·min-1 (Oncpeak) and -0.2 mL O2·kg-1·min-1 (Oncsub). Eighty-six percent (n = 325) and 76% (n = 283) estimated Vo2peak values were within ±3.5 mL O2·kg-1·min-1 of the measured Vo2peak values for Oncpeak and Oncsub, respectively.ConclusionsHF-FRIEND or oncology-specific equations could be applied to estimate Vo2peak in patients previously treated for breast cancer in settings where cardiopulmonary exercise tests are not available. (Trial Comparing the Effects of Linear Versus Nonlinear Aerobic Training in Women With Operable Breast Cancer [EXCITE]; NCT01186367.
| S-EPMC9270626 | biostudies-literature
Project description:BackgroundCaloric restriction and exercise are lifestyle interventions that effectively attenuate cardiometabolic impairment. However, cardioprotective effects of long-term lifestyle interventions and short-term lifestyle interventions followed by weight maintenance in prediabetes have never been compared. High cardiorespiratory fitness (CRF) has been shown to provide protection against prediabetes and cardiovascular diseases, however, the interactions between CRF, prediabetes, caloric restriction, and exercise on cardiometabolic health has never been investigated.MethodsSeven-week-old male Wistar rats were fed with either a normal diet (ND; n = 6) or a high-fat diet (HFD; n = 30) to induce prediabetes for 12 weeks. Baseline CRF and cardiometabolic parameters were determined at this timepoint. The ND-fed rats were fed continuously with a ND for 16 more weeks. The HFD-fed rats were divided into 5 groups (n = 6/group) to receive one of the following: (1) a HFD without any intervention for 16 weeks, (2) 40% caloric restriction for 6 weeks followed by an ad libitum ND for 10 weeks, (3) 40% caloric restriction for 16 weeks, (4) a HFD plus an exercise training program for 6 weeks followed by a ND without exercise for 10 weeks, or (5) a HFD plus an exercise training program for 16 weeks. At the end of the interventions, CRF and cardiometabolic parameters were re-assessed. Then, all rats were euthanized and heart tissues were collected.ResultsEither short-term caloric restriction or exercise followed by weight maintenance ameliorated cardiometabolic impairment in prediabetes, as indicated by increased insulin sensitivity, improved blood lipid profile, improved mitochondrial function and oxidative phosphorylation, reduced oxidative stress and inflammation, and improved cardiac function. However, these benefits were not as effective as those of either long-term caloric restriction or exercise. Interestingly, high-level baseline CRF was correlated with favorable cardiac and metabolic profiles at follow-up in prediabetic rats, both with and without lifestyle interventions.ConclusionsShort-term lifestyle modification followed by weight maintenance improves cardiometabolic health in prediabetes. High CRF exerted protection against cardiometabolic impairment in prediabetes, both with and without lifestyle modification. These findings suggest that targeting the enhancement of CRF may contribute to the more effective treatment of prediabetes-induced cardiometabolic impairment.
| S-EPMC8908596 | biostudies-literature
Project description:The added value of non-exercise-based estimation of cardiorespiratory fitness (eCRF) to cardiovascular disease (CVD) risk factors for mortality risk has not been examined in Korean populations. This population-based prospective cohort study examined the relationship of the 10-year Framingham risk score (FRS) for CVD risk and eCRF with all-cause and CVD mortality in a representative sample of Korean adults aged 30 years and older. Data regarding a total of 38,350 participants (16,505 men/21,845 women) were obtained from the 2007-2015 Korea National Health and Nutrition Examination Survey (KNHANES). All-cause and CVD mortality were the main outcomes. The 10-year FRS point sum and eCRF level were the main exposures. All-cause and CVD mortality was positively correlated with the 10-year FRS point summation and inversely correlated with eCRF level in this study population. The protective of high eCRF against all-cause and CVD mortality was more prominent in the middle and high FRS category than in the low FRS category. Notably, the FRS plus eCRF model has better predictor power for estimating mortality risk compared to the FRS only model. The current findings indicate that eCRF can be used as an alternative to objectively measured CRF for mortality risk prediction.
| S-EPMC8744979 | biostudies-literature