Blair S N, Kohl H W, Barlow C E, Paffenbarger R S, Gibbons L W, Macera C A
Division of Epidemiology, Cooper Institute for Aerobics Research, Dallas, TX 75230, USA.
JAMA. 1995 Apr 12;273(14):1093-8.
To evaluate the relationship between changes in physical fitness and risk of mortality in men.
Prospective study, with two clinical examinations (mean interval between examinations, 4.9 years) to assess change or lack of change in physical fitness as associated with risk of mortality during follow-up after the subsequent examination (mean follow-up from subsequent examination, 5.1 years).
Preventive medicine clinic.
Participants were 9777 men given two preventive medical examinations, each of which included assessment of physical fitness by maximal exercise tests and evaluation of health status.
All cause (n = 223) and cardiovascular disease (n = 87) mortality.
The highest age-adjusted all-cause death rate was observed in men who were unfit at both examinations (122.0/10,000 man-years); the lowest death rate was in men who were physically fit at both examinations (39.6/10,000 man-years). Men who improved from unfit to fit between the first and subsequent examinations had an age-adjusted death rate of 67.7/10,000 man-years. This is a reduction in mortality risk of 44% (95% confidence interval, 25% to 59%) relative to men who remained unfit at both examinations. Improvement in fitness was associated with lower death rates after adjusting for age, health status, and other risk factors of premature mortality. For each minute increase in maximal treadmill time between examinations, there was a corresponding 7.9% (P = .001) decrease in risk of mortality. Similar results were seen when the group was stratified by health status, and for cardiovascular disease mortality.
Men who maintained or improved adequate physical fitness were less likely to die from all causes and from cardiovascular disease during follow-up than persistently unfit men. Physicians should encourage unfit men to improve their fitness by starting a physical activity program.
评估男性身体素质变化与死亡风险之间的关系。
前瞻性研究，进行两次临床检查（检查之间的平均间隔为4.9年），以评估身体素质的变化或未变化情况，并将其与后续检查后随访期间的死亡风险相关联（后续检查后的平均随访时间为5.1年）。
预防医学诊所。
9777名男性接受了两次预防性医学检查，每次检查都包括通过最大运动测试评估身体素质和评估健康状况。
全因死亡（n = 223）和心血管疾病死亡（n = 87）。
在两次检查时均身体不健康的男性中观察到最高的年龄调整全因死亡率（122.0/10000人年）；最低死亡率出现在两次检查时均身体健康的男性中（39.6/10000人年）。在第一次检查和后续检查之间从不健康改善为健康的男性年龄调整死亡率为67.7/10000人年。相对于两次检查时均保持不健康的男性，这使死亡风险降低了44%（95%置信区间，25%至59%）。在调整年龄、健康状况和其他过早死亡风险因素后，身体素质的改善与较低的死亡率相关。每次检查之间最大跑步机运动时间每增加一分钟，死亡风险相应降低7.9%（P = .001）。当按健康状况分层该组时，以及对于心血管疾病死亡率，也观察到类似结果。
在随访期间，保持或改善适当身体素质的男性比持续不健康的男性死于全因和心血管疾病的可能性更小。医生应鼓励身体不健康的男性通过启动体育活动计划来改善身体素质。
