ArticlesChanges in physical fitness and changes in mortality
Introduction
Studies based on point estimates of physical fitness show that such estimates are a good long-term predictor of cardiovascular mortality and all-cause mortality in healthy people.1, 2, 3, 4, 5, 6, 7 However, these studies generally assume a homogenous decline in physical fitness with age throughout the population. Patterns of physical fitness may in fact vary between subgroups because of, for example, changes in physical activity and smoking habits over time: the Global Burden of Disease Study8 puts physical inactivity and smoking among the top ten risk factors that threaten global health. Information on changes in physical fitness and lifestyle may provide more information on long-term prognosis than can be obtained from a single estimate.
To study the relations between physical fitness, changes in physical fitness, and mortality, we tested the physical fitness of a group of apparently healthy middle-aged men. The men were tested on two occasions, with an interval of 7 years. Total follow-up time was 22 years.
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Participants
2014 men aged 40–60 years took part in a baseline survey (survey 1) in 1972–75.9 Men were defined as “apparently healthy” if they had no evidence of heart disease, no diagnosed hypertension requiring drug treatment, and no diabetes mellitus, cancer, advanced pulmonary, renal, or liver disease, or other serious disorders, and were able to undertake a symptom-limited exercise test. 1756 (91%) of the men participated in a second identical survey in 1980–82 (survey 2), and our study uses these data.
Results
The results of survey 2 (table 1) show significant variation according to age-adjusted physical fitness in blood concentrations of triglycerides, heart rate, systolic blood pressure, body-mass index, amounts of physical activity, vital capacity, smoking status, and exercise-ECG findings. For all these variables, the highest quartile of physical fitness had the values indicating lowest risk. Total cholesterol concentration was not significantly associated with physical fitness. Between-group
Discussion
Our data from a group of healthy men show that not only fitness itself, but also the magnitude and direction of changes in fitness observed over a period of 7 years, give important information on the risk of death during a follow-up period of up to 15 years. Good physical fitness suggests the presence of normal cardiorespiratory function, efficient oxygen transport and uptake, muscular and skeletal function, and psychological fitness. Physical fitness may therefore be a good surrogate measure
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