Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9047, USA.
J Am Coll Cardiol. 2011 Apr 12;57(15):1604-10. doi: 10.1016/j.jacc.2010.10.056.
The purpose of this study was to determine the association between fitness and lifetime risk for cardiovascular disease (CVD).
Higher levels of traditional risk factors are associated with marked differences in lifetime risks for CVD. However, data are sparse regarding the association between fitness and the lifetime risk for CVD.
We followed up 11,049 men who underwent clinical examination at the Cooper Institute in Dallas, Texas, before 1990 until the occurrence of CVD death, non-CVD death, or attainment of age 90 years (281,469 person-years of follow-up, median follow-up 25.3 years, 1,106 CVD deaths). Fitness was measured by the Balke protocol and categorized according to treadmill time into low, moderate, and high fitness, with further stratification by CVD risk factor burden. Lifetime risk for CVD death determined by the National Death Index was estimated for fitness levels measured at ages 45, 55, and 65 years, with non-CVD death as the competing event.
Differences in fitness levels (low fitness vs. high fitness) were associated with marked differences in the lifetime risks for CVD death at each index age: age 45 years, 13.7% versus 3.4%; age 55 years, 34.2% versus 15.3%; and age 65 years, 35.6% versus 17.1%. These associations were strongest among persons with CVD risk factors.
A single measurement of low fitness in mid-life was associated with higher lifetime risk for CVD death, particularly among persons with a high burden of CVD risk factors.
本研究旨在确定健康水平与心血管疾病（CVD）终生风险之间的关系。
较高水平的传统危险因素与 CVD 终生风险的显著差异相关。然而，关于健康水平与 CVD 终生风险之间的关系的数据仍然很少。
我们对在德克萨斯州达拉斯库珀研究所接受临床检查的 11049 名男性进行了随访，随访时间为 1990 年之前，直到发生 CVD 死亡、非 CVD 死亡或达到 90 岁（281469 人年随访，中位随访时间 25.3 年，1106 例 CVD 死亡）。健康水平通过巴尔克方案测量，并根据跑步机时间分为低、中、高健康水平，进一步按 CVD 危险因素负担分层。通过国家死亡索引确定 CVD 死亡的终生风险，估计在 45、55 和 65 岁时测量的健康水平，以非 CVD 死亡为竞争事件。
健康水平（低健康水平与高健康水平）的差异与每个指数年龄的 CVD 死亡终生风险的显著差异相关：年龄 45 岁，13.7%比 3.4%；年龄 55 岁，34.2%比 15.3%；年龄 65 岁，35.6%比 17.1%。这些关联在有 CVD 危险因素的人群中最强。
中年时单次低健康水平测量与 CVD 死亡的终生风险增加相关，尤其是在 CVD 危险因素负担较高的人群中。
