Combined effect of cardiorespiratory fitness and adiposity on mortality in patients with coronary artery disease
High cardiorespiratory fitness and body mass index (BMI) are associated with decreased mortality in patients with coronary artery disease. Our objective was to determine the joint impact of fitness and adiposity measures on all-cause mortality in this subgroup. Coronary artery disease patients (n =...
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| Vydáno v: | The American heart journal Ročník 161; číslo 3; s. 590 - 597 |
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| Hlavní autoři: | , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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New York, NY
Elsevier Inc
01.03.2011
Mosby Elsevier Limited |
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| ISSN: | 0002-8703, 1097-6744, 1097-6744 |
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| Abstract | High cardiorespiratory fitness and body mass index (BMI) are associated with decreased mortality in patients with coronary artery disease. Our objective was to determine the joint impact of fitness and adiposity measures on all-cause mortality in this subgroup.
Coronary artery disease patients (n = 855) enrolled in the Mayo Clinic cardiac rehabilitation program from 1993 to 2007 were included. Fitness levels were determined by cardiopulmonary exercise testing. Patients were divided into low and high fitness by sex-specific median values of peak oxygen consumption and total treadmill time. Adiposity was measured through BMI and waist-to-hip ratio (WHR).
There were 159 deaths during 9.7 ± 3.6 years of mean follow-up. After adjusting for potential confounding factors, low fitness, shorter treadmill time, low BMI, and high WHR were significantly associated with increased mortality. Using low WHR–high fitness group as reference, significantly increased mortality was noted in low WHR–low fitness (hazard ratio 4.2, 95% CI, 1.8-9.8), centrally obese–high fitness (2.3, 1.0-5.4), and centrally obese–low fitness (6.1, 2.7-13.6) groups. Overweight–high fitness (2.2, 0.63-7.4), obese–high fitness (3.2, 0.88-11.4), and obese–low fitness (3.3, 0.96-11.4) subjects did not have a significantly different mortality as compared with the reference group of normal weight–high fitness subjects, whereas normal weight–low fitness (9.6, 2.9-31.8) and overweight–low fitness (6.8, 2.1-22.2) groups had significantly increased mortality.
Low fitness and central obesity were independently and cumulatively associated with increased mortality in coronary artery disease patients attending cardiac rehabilitation. The association of BMI with mortality is complex and altered by fitness levels. |
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| AbstractList | Background High cardiorespiratory fitness and body mass index (BMI) are associated with decreased mortality in patients with coronary artery disease. Our objective was to determine the joint impact of fitness and adiposity measures on all-cause mortality in this subgroup. Methods Coronary artery disease patients (n = 855) enrolled in the Mayo Clinic cardiac rehabilitation program from 1993 to 2007 were included. Fitness levels were determined by cardiopulmonary exercise testing. Patients were divided into low and high fitness by sex-specific median values of peak oxygen consumption and total treadmill time. Adiposity was measured through BMI and waist-to-hip ratio (WHR). Results There were 159 deaths during 9.7 ± 3.6 years of mean follow-up. After adjusting for potential confounding factors, low fitness, shorter treadmill time, low BMI, and high WHR were significantly associated with increased mortality. Using low WHR-high fitness group as reference, significantly increased mortality was noted in low WHR-low fitness (hazard ratio 4.2, 95% CI, 1.8-9.8), centrally obese-high fitness (2.3, 1.0-5.4), and centrally obese-low fitness (6.1, 2.7-13.6) groups. Overweight-high fitness (2.2, 0.63-7.4), obese-high fitness (3.2, 0.88-11.4), and obese-low fitness (3.3, 0.96-11.4) subjects did not have a significantly different mortality as compared with the reference group of normal weight-high fitness subjects, whereas normal weight-low fitness (9.6, 2.9-31.8) and overweight-low fitness (6.8, 2.1-22.2) groups had significantly increased mortality. Conclusions Low fitness and central obesity were independently and cumulatively associated with increased mortality in coronary artery disease patients attending cardiac rehabilitation. The association of BMI with mortality is complex and altered by fitness levels. Background High cardiorespiratory fitness and body mass index (BMI) are associated with decreased mortality in patients with coronary artery disease. Our objective was to determine the joint impact of fitness and adiposity measures on all-cause mortality in this subgroup. Methods Coronary artery disease patients (n = 855) enrolled in the Mayo Clinic cardiac rehabilitation program from 1993 to 2007 were included. Fitness levels were determined by cardiopulmonary exercise testing. Patients were divided into low and high fitness by sex-specific median values of peak oxygen consumption and total treadmill time. Adiposity was measured through BMI and waist-to-hip ratio (WHR). Results There were 159 deaths during 9.7 plus or minus 3.6 years of mean follow-up. After adjusting for potential confounding factors, low fitness, shorter treadmill time, low BMI, and high WHR were significantly associated with increased mortality. Using low WHR-high fitness group as reference, significantly increased mortality was noted in low WHR-low fitness (hazard ratio 4.2, 95% CI, 1.8-9.8), centrally obese-high fitness (2.3, 1.0-5.4), and centrally obese-low fitness (6.1, 2.7-13.6) groups. Overweight-high fitness (2.2, 0.63-7.4), obese-high fitness (3.2, 0.88-11.4), and obese-low fitness (3.3, 0.96-11.4) subjects did not have a significantly different mortality as compared with the reference group of normal weight-high fitness subjects, whereas normal weight-low fitness (9.6, 2.9-31.8) and overweight-low fitness (6.8, 2.1-22.2) groups had significantly increased mortality. Conclusions Low fitness and central obesity were independently and cumulatively associated with increased mortality in coronary artery disease patients attending cardiac rehabilitation. The association of BMI with mortality is complex and altered by fitness levels. High cardiorespiratory fitness and body mass index (BMI) are associated with decreased mortality in patients with coronary artery disease. Our objective was to determine the joint impact of fitness and adiposity measures on all-cause mortality in this subgroup. Coronary artery disease patients (n = 855) enrolled in the Mayo Clinic cardiac rehabilitation program from 1993 to 2007 were included. Fitness levels were determined by cardiopulmonary exercise testing. Patients were divided into low and high fitness by sex-specific median values of peak oxygen consumption and total treadmill time. Adiposity was measured through BMI and waist-to-hip ratio (WHR). There were 159 deaths during 9.7 ± 3.6 years of mean follow-up. After adjusting for potential confounding factors, low fitness, shorter treadmill time, low BMI, and high WHR were significantly associated with increased mortality. Using low WHR–high fitness group as reference, significantly increased mortality was noted in low WHR–low fitness (hazard ratio 4.2, 95% CI, 1.8-9.8), centrally obese–high fitness (2.3, 1.0-5.4), and centrally obese–low fitness (6.1, 2.7-13.6) groups. Overweight–high fitness (2.2, 0.63-7.4), obese–high fitness (3.2, 0.88-11.4), and obese–low fitness (3.3, 0.96-11.4) subjects did not have a significantly different mortality as compared with the reference group of normal weight–high fitness subjects, whereas normal weight–low fitness (9.6, 2.9-31.8) and overweight–low fitness (6.8, 2.1-22.2) groups had significantly increased mortality. Low fitness and central obesity were independently and cumulatively associated with increased mortality in coronary artery disease patients attending cardiac rehabilitation. The association of BMI with mortality is complex and altered by fitness levels. High cardiorespiratory fitness and body mass index (BMI) are associated with decreased mortality in patients with coronary artery disease. Our objective was to determine the joint impact of fitness and adiposity measures on all-cause mortality in this subgroup.BACKGROUNDHigh cardiorespiratory fitness and body mass index (BMI) are associated with decreased mortality in patients with coronary artery disease. Our objective was to determine the joint impact of fitness and adiposity measures on all-cause mortality in this subgroup.Coronary artery disease patients (n = 855) enrolled in the Mayo Clinic cardiac rehabilitation program from 1993 to 2007 were included. Fitness levels were determined by cardiopulmonary exercise testing. Patients were divided into low and high fitness by sex-specific median values of peak oxygen consumption and total treadmill time. Adiposity was measured through BMI and waist-to-hip ratio (WHR).METHODSCoronary artery disease patients (n = 855) enrolled in the Mayo Clinic cardiac rehabilitation program from 1993 to 2007 were included. Fitness levels were determined by cardiopulmonary exercise testing. Patients were divided into low and high fitness by sex-specific median values of peak oxygen consumption and total treadmill time. Adiposity was measured through BMI and waist-to-hip ratio (WHR).There were 159 deaths during 9.7 ± 3.6 years of mean follow-up. After adjusting for potential confounding factors, low fitness, shorter treadmill time, low BMI, and high WHR were significantly associated with increased mortality. Using low WHR-high fitness group as reference, significantly increased mortality was noted in low WHR-low fitness (hazard ratio 4.2, 95% CI, 1.8-9.8), centrally obese-high fitness (2.3, 1.0-5.4), and centrally obese-low fitness (6.1, 2.7-13.6) groups. Overweight-high fitness (2.2, 0.63-7.4), obese-high fitness (3.2, 0.88-11.4), and obese-low fitness (3.3, 0.96-11.4) subjects did not have a significantly different mortality as compared with the reference group of normal weight-high fitness subjects, whereas normal weight-low fitness (9.6, 2.9-31.8) and overweight-low fitness (6.8, 2.1-22.2) groups had significantly increased mortality.RESULTSThere were 159 deaths during 9.7 ± 3.6 years of mean follow-up. After adjusting for potential confounding factors, low fitness, shorter treadmill time, low BMI, and high WHR were significantly associated with increased mortality. Using low WHR-high fitness group as reference, significantly increased mortality was noted in low WHR-low fitness (hazard ratio 4.2, 95% CI, 1.8-9.8), centrally obese-high fitness (2.3, 1.0-5.4), and centrally obese-low fitness (6.1, 2.7-13.6) groups. Overweight-high fitness (2.2, 0.63-7.4), obese-high fitness (3.2, 0.88-11.4), and obese-low fitness (3.3, 0.96-11.4) subjects did not have a significantly different mortality as compared with the reference group of normal weight-high fitness subjects, whereas normal weight-low fitness (9.6, 2.9-31.8) and overweight-low fitness (6.8, 2.1-22.2) groups had significantly increased mortality.Low fitness and central obesity were independently and cumulatively associated with increased mortality in coronary artery disease patients attending cardiac rehabilitation. The association of BMI with mortality is complex and altered by fitness levels.CONCLUSIONSLow fitness and central obesity were independently and cumulatively associated with increased mortality in coronary artery disease patients attending cardiac rehabilitation. The association of BMI with mortality is complex and altered by fitness levels. |
| Author | Squires, Ray W. Trejo-Gutierrez, Jorge F. Thomas, Randal J. Lopez-Jimenez, Francisco Somers, Virend K. Goel, Kashish Coutinho, Thais Miles, John M. |
| Author_xml | – sequence: 1 givenname: Kashish surname: Goel fullname: Goel, Kashish organization: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN – sequence: 2 givenname: Randal J. surname: Thomas fullname: Thomas, Randal J. organization: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN – sequence: 3 givenname: Ray W. surname: Squires fullname: Squires, Ray W. organization: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN – sequence: 4 givenname: Thais surname: Coutinho fullname: Coutinho, Thais organization: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN – sequence: 5 givenname: Jorge F. surname: Trejo-Gutierrez fullname: Trejo-Gutierrez, Jorge F. organization: Division of Cardiovascular Diseases, Mayo Clinic, Jacksonville, FL – sequence: 6 givenname: Virend K. surname: Somers fullname: Somers, Virend K. organization: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN – sequence: 7 givenname: John M. surname: Miles fullname: Miles, John M. organization: Division of Endocrinology, Mayo Clinic, Rochester, MN – sequence: 8 givenname: Francisco surname: Lopez-Jimenez fullname: Lopez-Jimenez, Francisco email: lopez@mayo.edu organization: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN |
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| Snippet | High cardiorespiratory fitness and body mass index (BMI) are associated with decreased mortality in patients with coronary artery disease. Our objective was to... Background High cardiorespiratory fitness and body mass index (BMI) are associated with decreased mortality in patients with coronary artery disease. Our... |
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| SubjectTerms | Adiposity - physiology Aged Biological and medical sciences Body Mass Index Cardiology. Vascular system Cardiovascular Coronary Artery Disease - mortality Coronary heart disease Coronary vessels Exercise Test Female Heart Heart attacks Humans Male Medical sciences Middle Aged Mortality Obesity Obesity - epidemiology Oxygen Consumption Physical Fitness Proportional Hazards Models |
| Title | Combined effect of cardiorespiratory fitness and adiposity on mortality in patients with coronary artery disease |
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