Self-reported cardiorespiratory fitness: prediction and classification of risk of cardiovascular disease mortality and longevity - a prospective investigation in the Copenhagen City Heart Study

TY - JOUR

T1 - Self-reported cardiorespiratory fitness

T2 - prediction and classification of risk of cardiovascular disease mortality and longevity - a prospective investigation in the Copenhagen City Heart Study

AU - Holtermann, Andreas

AU - Marott, Jacob Louis

AU - Gyntelberg, Finn

AU - Søgaard, Karen

AU - Mortensen, Ole Steen

AU - Prescott, Eva

AU - Schnohr, Peter

N1 - © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

PY - 2015/1/27

Y1 - 2015/1/27

N2 - BACKGROUND: The predictive value and improved risk classification of self-reported cardiorespiratory fitness (SRCF), when added to traditional risk factors on cardiovascular disease (CVD) and longevity, are unknown.METHODS AND RESULTS: A total of 3843 males and 5093 females from the Copenhagen City Heart Study without CVD in 1991-1994 were analyzed using multivariate Cox hazards regression to assess the predictive value and survival benefit for CVD and all-cause mortality from SRCF. The category-free net reclassification improvement from SRCF was calculated at 15-year follow-up on CVD and all-cause mortality. Overall, 1693 individuals died from CVD. In the fully adjusted Cox model, those reporting the same (hazard ratio [HR], 1.17; 95% confidence interval [CI], 1.04 to 1.32) and lower (HR, 1.91; 95% CI, 1.62 to 2.24) SRCF than peers had an increased risk of CVD mortality, compared with individuals with higher SRCF. Compared with individuals with higher SRCF, those with the same and lower SRCF had 1.8 (95% CI, 1.0 to 2.5) and 5.1 (95% CI, 4.1 to 6.2) years lower life expectancy, respectively. Individuals with lower SRCF had a significantly increased risk of CVD mortality, compared with individuals with higher SRCF, within each strata of leisure time physical activity and self-rated health, and SRCF significantly predicted CVD mortality independently of self-rated health and walking pace. A net reclassification improvement of 30.5% (95% CI, 22.1% to 38.9%) for CVD mortality was found when adding SRCF to traditional risk factors. Comparable findings were found for all-cause mortality.CONCLUSIONS: SRCF has independent predictive value, is related to a considerable survival benefit, and improves risk classification when added to traditional risk factors of CVD and all-cause mortality. SRCF might prove useful in improved risk stratification in primary prevention.

AB - BACKGROUND: The predictive value and improved risk classification of self-reported cardiorespiratory fitness (SRCF), when added to traditional risk factors on cardiovascular disease (CVD) and longevity, are unknown.METHODS AND RESULTS: A total of 3843 males and 5093 females from the Copenhagen City Heart Study without CVD in 1991-1994 were analyzed using multivariate Cox hazards regression to assess the predictive value and survival benefit for CVD and all-cause mortality from SRCF. The category-free net reclassification improvement from SRCF was calculated at 15-year follow-up on CVD and all-cause mortality. Overall, 1693 individuals died from CVD. In the fully adjusted Cox model, those reporting the same (hazard ratio [HR], 1.17; 95% confidence interval [CI], 1.04 to 1.32) and lower (HR, 1.91; 95% CI, 1.62 to 2.24) SRCF than peers had an increased risk of CVD mortality, compared with individuals with higher SRCF. Compared with individuals with higher SRCF, those with the same and lower SRCF had 1.8 (95% CI, 1.0 to 2.5) and 5.1 (95% CI, 4.1 to 6.2) years lower life expectancy, respectively. Individuals with lower SRCF had a significantly increased risk of CVD mortality, compared with individuals with higher SRCF, within each strata of leisure time physical activity and self-rated health, and SRCF significantly predicted CVD mortality independently of self-rated health and walking pace. A net reclassification improvement of 30.5% (95% CI, 22.1% to 38.9%) for CVD mortality was found when adding SRCF to traditional risk factors. Comparable findings were found for all-cause mortality.CONCLUSIONS: SRCF has independent predictive value, is related to a considerable survival benefit, and improves risk classification when added to traditional risk factors of CVD and all-cause mortality. SRCF might prove useful in improved risk stratification in primary prevention.

KW - Adult

KW - Age Factors

KW - Cardiovascular Diseases

KW - Cause of Death

KW - Cohort Studies

KW - Denmark

KW - Female

KW - Humans

KW - Longevity

KW - Male

KW - Middle Aged

KW - Physical Fitness

KW - Predictive Value of Tests

KW - Prospective Studies

KW - Self Report

KW - Sex Factors

KW - Urban Population

U2 - 10.1161/JAHA.114.001495

DO - 10.1161/JAHA.114.001495

M3 - Journal article

C2 - 25628408

SN - 2047-9980

VL - 4

SP - 1

EP - 8

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

M1 - e001495

ER -