Kokkinos Peter, Doumas Michael, Myers Jonathan, Faselis Charles, Manolis Athanasios, Pittaras Andreas, Kokkinos John Peter, Papademetriou Vasilios, Singh Steven, Fletcher Ross D
Veterans Affairs Medical Center, Washington, DC 20422, USA.
Blood Press. 2009;18(5):261-7. doi: 10.3109/08037050903272859.
Information regarding the effect of exercise capacity on mortality risk in individuals with high-normal blood pressure is severely limited. Thus, we evaluated the association of exercise capacity and all-cause mortality in individuals with high-normal blood pressure.
Exercise test was performed in 1727 males with high-normal blood pressure at two Veteran sites (Washington, DC, and Palo Alto, CA). Fitness status was assessed in metabolic equivalents (METs) at exercise peak. All-cause mortality was recorded for a mean follow-up period of 9.8+/-6.0 years.
Exercise capacity was inversely associated with all-cause mortality, and the association was independent of traditional cardiovascular risk factors. For each 1 MET increase in exercise capacity, the adjusted mortality risk was reduced by 13%, underscoring the strong predictive value of exercise capacity that was confirmed by ROC analysis. Data analysis according to fitness levels revealed a threshold level of 4 METs, over which the mortality risk was progressively reduced by 30% (hazard ratio=0.70; CI 0.51-0.95) for those who achieved 4.1-6.0 METs and 61% (hazard ratio=0.39; CI 0.26-0.57) for those who achieved 8.1-10 METs. No additional reductions in risk were noted until the MET level achieved exceeded 12 METs.
We observed a strong, inverse, graded and independent association between exercise capacity and all-cause mortality in individuals with high-normal blood pressure. Our findings indicate that a shift of the fitness curve to the right is associated with significant survival benefits, and even slight differences in fitness levels are associated with substantial reductions in mortality risk.
关于运动能力对血压略高于正常水平个体的死亡风险影响的信息极为有限。因此，我们评估了血压略高于正常水平个体的运动能力与全因死亡率之间的关联。
对两个退伍军人医疗点（华盛顿特区和加利福尼亚州帕洛阿尔托）的1727名血压略高于正常水平的男性进行了运动测试。运动峰值时的体能状态以代谢当量（METs）进行评估。记录全因死亡率，平均随访时间为9.8±6.0年。
运动能力与全因死亡率呈负相关，且这种关联独立于传统心血管危险因素。运动能力每增加1 MET，校正后的死亡风险降低13%，强调了运动能力的强大预测价值，这一点通过ROC分析得到证实。根据体能水平进行的数据分析显示，阈值水平为4 METs，达到4.1 - 6.0 METs的个体，其死亡风险逐步降低30%（风险比 = 0.70；95%置信区间0.51 - 0.95），达到8.1 - 10 METs的个体，其死亡风险降低61%（风险比 = 0.39；95%置信区间0.26 - 0.57）。直到MET水平超过12 METs，才观察到风险进一步降低。
我们观察到血压略高于正常水平个体的运动能力与全因死亡率之间存在强烈、负向、分级且独立的关联。我们的研究结果表明，体能曲线右移与显著的生存益处相关，即使体能水平存在细微差异也与死亡风险的大幅降低相关。
