Comparison of cardiorespiratory fitness versus leisure time physical activity as predictors of coronary events in men aged < or = 65 years and > 65 years.
Both high peak oxygen consumption (VO(2)) and high levels of leisure time physical activity (LTPA) are associated with a reduced risk of cardiovascular morbidity and mortality. We examined the contributions of LTPA and peak VO(2) to the risk of coronary events (CEs) in healthy younger (< or = 65 years, n = 522) and older (>65 years, n = 167) men from the Baltimore Longitudinal Study of Aging. LTPA derived from self reports of time spent in 97 activities were converted into METs-minutes/24 hours and grouped into high (> or = 6 METs), moderate- (4 to 5.9 METs), and low-intensity LTPA (<4 METs). Cardiorespiratory fitness was determined by measuring peak VO(2) during a maximal treadmill exercise test. Over a mean follow-up of 13.4 +/- 6.3 years, CEs occurred in 63 men. After accounting for coronary risk factors, proportional-hazards analyses showed a relative CE risk of 0.53 (p <0.0001) for a SD increase in peak VO(2) in younger men and 0.61 (p = 0.024) in older men, whereas total LTPA was unrelated to coronary risk in either age group. When the 3 LTPA intensity levels were substituted for total LTPA in the model, peak VO(2) remained the only predictor of events in younger men, whereas high-intensity LTPA (RR = 0.39 for tertile 3 vs tertiles 1 and 2, p = 0.016) and peak VO(2) (RR = 0.61/SD increase, p = 0.024) were of similar importance in older men. Thus, in healthy younger men, higher cardiorespiratory fitness but not LTPA predicts a reduced risk of coronary heart disease, independent of conventional risk factors. For older men, high-intensity LTPA and fitness appear to be of similar importance in reducing coronary risk.
Talbot
Laura A
LA
The Johns Hopkins University, School of Nursing, Baltimore, Maryland 21205-2110, USA. ltalbot@son.jhmi.edu
Morrell
Christopher H
CH
Metter
E Jeffrey
EJ
Fleg
Jerome L
JL
D000328:Adult; D000367:Age Factors; D000368:Aged; D015142:Baltimore / Q000453:epidemiology; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000453:epidemiology / Q000503:physiopathology*; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005500:Follow-Up Studies; D006321:Heart / Q000502:physiology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008168:Lung / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D010807:Physical Endurance / Q000502:physiology*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012016:Reference Values; D012307:Risk Factors; D016019:Survival Analysis
D002784:Cholesterol