Farrell S W, Kampert J B, Kohl H W, Barlow C E, Macera C A, Paffenbarger R S, Gibbons L W, Blair S N
Cooper Institute for Aerobics Research, Dallas, TX 75230, USA.
Med Sci Sports Exerc. 1998 Jun;30(6):899-905. doi: 10.1097/00005768-199806000-00019.
This investigation quantifies the relation between cardiorespiratory fitness levels and cardiovascular disease (CVD) mortality within strata of other CVD predictors.
Participants included 25,341 male Cooper Clinic patients who underwent a maximal graded exercise test. CVD death rates were determined for low (least fit one-fifth), moderate (next two-fifths), and high (top two-fifths) cardiorespiratory fitness categories by strata of smoking habit, blood cholesterol level, resting blood pressure, and health status. There were 226 cardiovascular deaths during 211,996 man-years of follow-up.
For individuals with none of the major CVD predictors (smoking, elevated resting systolic blood pressure, elevated blood cholesterol), there was a strong inverse relation (P = 0.001) between fitness level and CVD mortality. An inverse relation between CVD mortality and fitness level was seen within strata of cholesterol levels and health status. No evidence of a trend (P = 0.60) for decreased mortality was seen across fitness levels for individuals with elevated systolic blood pressure; however, a strong inverse gradient (P < 0.001) was seen across fitness levels for individuals with normal systolic blood pressure. There was a tendency for association between high levels of fitness and decreased CVD mortality in smokers compared with low and moderately fit smokers (P < 0.076). There was no significant association between level of fitness and CVD mortality for individuals with multiple (two or more) predictors (P = 0.325). Approximately 20% of the 226 CVD deaths in the population studied were attributed to low fitness level.
Moderate and high levels of cardiorespiratory fitness seem to provide some protection from CVD mortality, even in the presence of well established CVD predictors.
本研究量化了在其他心血管疾病（CVD）预测因素分层中，心肺适能水平与CVD死亡率之间的关系。
参与者包括25341名接受最大分级运动试验的男性库珀诊所患者。根据吸烟习惯、血胆固醇水平、静息血压和健康状况分层，确定低（最不适能的五分之一）、中（次两个五分之一）和高（最适能的两个五分之一）心肺适能类别的CVD死亡率。在211996人年的随访期间，共有226例心血管死亡病例。
对于没有主要CVD预测因素（吸烟、静息收缩压升高、血胆固醇升高）的个体，适能水平与CVD死亡率之间存在强烈的负相关（P = 0.001）。在胆固醇水平和健康状况分层中，可见CVD死亡率与适能水平之间呈负相关。对于收缩压升高的个体，未发现死亡率随适能水平降低的趋势（P = 0.60）；然而，对于收缩压正常的个体，可见适能水平之间存在强烈的负梯度（P < 0.001）。与低适能和中等适能的吸烟者相比，高适能吸烟者的CVD死亡率有降低的趋势（P < 0.076）。对于有多种（两个或更多）预测因素的个体，适能水平与CVD死亡率之间无显著关联（P = 0.325）。在所研究人群的226例CVD死亡病例中，约20%归因于低适能水平。
即使存在已明确的CVD预测因素，中等和高水平的心肺适能似乎也能为CVD死亡率提供一定的保护。
