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

Andreas Holtermann; Jacob Louis Marott; Finn Gyntelberg; Karen Søgaard; Ole Steen Mortensen; Eva Prescott; Peter Schnohr

doi:10.1161/JAHA.114.001495

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

Andreas Holtermann, Jacob Louis Marott, Finn Gyntelberg, Karen Søgaard, Ole Steen Mortensen, Eva Prescott, Peter Schnohr

25 Citations (Scopus)

Abstract

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.

Original language	English
Article number	e001495
Journal	American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease
Volume	4
Pages (from-to)	1-8
Number of pages	8
ISSN	2047-9980
DOIs	https://doi.org/10.1161/JAHA.114.001495
Publication status	Published - 27 Jan 2015

Keywords

Adult
Age Factors
Cardiovascular Diseases
Cause of Death
Cohort Studies
Denmark
Female
Humans
Longevity
Male
Middle Aged
Physical Fitness
Predictive Value of Tests
Prospective Studies
Self Report
Sex Factors
Urban Population

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1161/JAHA.114.001495Licence: CC BY-NC

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Holtermann, A., Marott, J. L., Gyntelberg, F., Søgaard, K., Mortensen, O. S., Prescott, E., & Schnohr, P. (2015). Self-reported cardiorespiratory fitness: prediction and classification of risk of cardiovascular disease mortality and longevity - a prospective investigation in the Copenhagen City Heart Study. American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease, 4, 1-8. [e001495]. https://doi.org/10.1161/JAHA.114.001495

Self-reported cardiorespiratory fitness : prediction and classification of risk of cardiovascular disease mortality and longevity - a prospective investigation in the Copenhagen City Heart Study. / Holtermann, Andreas; Marott, Jacob Louis; Gyntelberg, Finn et al.

In: American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease, Vol. 4, e001495, 27.01.2015, p. 1-8.

Research output: Contribution to journal › Journal article › Research › peer-review

Holtermann, A, Marott, JL, Gyntelberg, F, Søgaard, K, Mortensen, OS , Prescott, E & Schnohr, P 2015, 'Self-reported cardiorespiratory fitness: prediction and classification of risk of cardiovascular disease mortality and longevity - a prospective investigation in the Copenhagen City Heart Study', American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease, vol. 4, e001495, pp. 1-8. https://doi.org/10.1161/JAHA.114.001495

Holtermann A, Marott JL, Gyntelberg F, Søgaard K, Mortensen OS , Prescott E et al. Self-reported cardiorespiratory fitness: prediction and classification of risk of cardiovascular disease mortality and longevity - a prospective investigation in the Copenhagen City Heart Study. American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease. 2015 Jan 27;4:1-8. e001495. doi: 10.1161/JAHA.114.001495

Holtermann, Andreas ; Marott, Jacob Louis ; Gyntelberg, Finn et al. / Self-reported cardiorespiratory fitness : prediction and classification of risk of cardiovascular disease mortality and longevity - a prospective investigation in the Copenhagen City Heart Study. In: American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease. 2015 ; Vol. 4. pp. 1-8.

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abstract = "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.",

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author = "Andreas Holtermann and Marott, {Jacob Louis} and Finn Gyntelberg and Karen S{\o}gaard and Mortensen, {Ole Steen} and Eva Prescott and Peter Schnohr",

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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

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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.

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KW - Female

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KW - Longevity

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KW - Middle Aged

KW - Physical Fitness

KW - Predictive Value of Tests

KW - Prospective Studies

KW - Self Report

KW - Sex Factors

KW - Urban Population

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JF - Journal of the American Heart Association

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ER -

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

Abstract

Keywords

UN SDGs

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