Cardiorespiratory Fitness, LDL Cholesterol, And Coronary Artery Disease Mortality In Men

Abstract

PURPOSE: To examine the prospective relationship among cardiorespiratory fitness (CRF), LDL cholesterol, and coronary artery disease (CAD) mortality in men. METHODS: 38,267 healthy men received a comprehensive baseline clinical exam between 1971 and 2006. CRF was determined from a maximal treadmill exercise test. Participants were divided into CRF categories of low (Quintile 1), moderate (Quintiles 2-3), and high (Quintiles 4-5) fit by age group, as well as by Adult Treatment Panel-III defined LDL categories. Hazard ratios (HR) for CAD mortality were computed with Cox regression analysis. RESULTS: During a mean follow-up period of 15.7 + 8.5 years, 463 CAD deaths occurred. A significant positive trend in adjusted CAD mortality was shown across decreasing categories of CRF (HR = 1.0, 1.36, and 2.78 for high, moderate, and low fit respectively, p trend < 0.0001). Adjusted HR's were significantly higher across increasing LDL categories (1.0, 1.55, 1.94, 2.62, and 2.93 respectively, p trend < 0.0001). When grouped by CRF category as well as by LDL category, there was a significant positive trend (p<0.05) in CAD mortality across decreasing categories of CRF within each LDL category. CONCLUSION: CRF is strongly and inversely associated with CAD mortality in men. Compared to men with a low CRF, attaining a moderate to high level of CRF attenuates the risk of CAD mortality within each category of LDL.