Purpose
To compare the contributions of fitness level and physical activity patterns to all-cause
mortality.
Methods
Of 6213 men referred for exercise testing between 1987 and 2000, 842 underwent an
assessment of adulthood activity patterns. The predictive power of exercise capacity
and activity patterns, along with clinical and exercise test data, were assessed for
all-cause mortality during a mean (±SD) follow-up of 5.5 ± 2 years.
Results
Expressing the data by age-adjusted quartiles, exercise capacity was a stronger predictor
of mortality than was activity pattern (hazard ratio [HR] = 0.56; 95% confidence interval
[CI]: 0.38 to 0.83; P < 0.001). In a multivariate analysis that considered clinical characteristics, risk
factors, exercise test data, and activity patterns, exercise capacity (HR per quartile
= 0.62; CI: 0.47 to 0.82; P < 0.001) and energy expenditure from adulthood recreational activity (HR per quartile
= 0.72; 95% CI: 0.58 to 0.89; P = 0.002) were the only significant predictors of mortality; these two variables were
stronger predictors than established risk factors such as smoking, hypertension, obesity,
and diabetes. Age-adjusted mortality decreased per quartile increase in exercise capacity
(HR for very low capacity = 1.0; HR for low = 0.59; HR for moderate = 0.46; HR for
high = 0.28; P < 0.001) and physical activity (HR for very low activity = 1.0; HR for low = 0.63;
HR for moderate = 0.42; HR for high = 0.38; P < 0.001). A 1000-kcal/wk increase in activity was approximately similar to a 1 metabolic
equivalent increase in fitness; both conferred a mortality benefit of 20%.
Conclusion
Exercise capacity determined from exercise testing and energy expenditure from weekly
activity outperform other clinical and exercise test variables in predicting all-cause
mortality.
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Article Info
Publication History
Accepted:
June 24,
2004
Received:
November 24,
2003
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
