title: Association between muscular strength and mortality in men: prospective cohort study.
abstract: OBJECTIVE
  To examine prospectively the association between muscular strength and mortality from all causes, cardiovascular disease, and cancer in men.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Aerobics centre longitudinal study.
  
  
  METHODS
  8762 men aged 20-80.
  
  
  METHODS
  All cause mortality up to 31 December 2003; muscular strength, quantified by combining one repetition maximal measures for leg and bench presses and further categorised as age specific thirds of the combined strength variable; and cardiorespiratory fitness assessed by a maximal exercise test on a treadmill.
  
  
  RESULTS
  During an average follow-up of 18.9 years, 503 deaths occurred (145 cardiovascular disease, 199 cancer). Age adjusted death rates per 10,000 person years across incremental thirds of muscular strength were 38.9, 25.9, and 26.6 for all causes; 12.1, 7.6, and 6.6 for cardiovascular disease; and 6.1, 4.9, and 4.2 for cancer (all P<0.01 for linear trend). After adjusting for age, physical activity, smoking, alcohol intake, body mass index, baseline medical conditions, and family history of cardiovascular disease, hazard ratios across incremental thirds of muscular strength for all cause mortality were 1.0 (referent), 0.72 (95% confidence interval 0.58 to 0.90), and 0.77 (0.62 to 0.96); for death from cardiovascular disease were 1.0 (referent), 0.74 (0.50 to 1.10), and 0.71 (0.47 to 1.07); and for death from cancer were 1.0 (referent), 0.72 (0.51 to 1.00), and 0.68 (0.48 to 0.97). The pattern of the association between muscular strength and death from all causes and cancer persisted after further adjustment for cardiorespiratory fitness; however, the association between muscular strength and death from cardiovascular disease was attenuated after further adjustment for cardiorespiratory fitness.
  
  
  CONCLUSIONS
  Muscular strength is inversely and independently associated with death from all causes and cancer in men, even after adjusting for cardiorespiratory fitness and other potential confounders.
authors.affiliation: Department of Biosciences and Nutrition at NOVUM, Unit for Preventive Nutrition, Karolinska Institutet, Huddinge, Sweden. ruizj@ugr.es
authors.forename: Jonatan R
authors.initials: JR
authors.lastname: Ruiz
authors.forename: Xuemei
authors.initials: X
authors.lastname: Sui
authors.forename: Felipe
authors.initials: F
authors.lastname: Lobelo
authors.forename: James R
authors.initials: JR
authors.lastname: Morrow
authors.forename: Allen W
authors.initials: AW
authors.lastname: Jackson
authors.forename: Michael
authors.initials: M
authors.lastname: Sjöström
authors.forename: Steven N
authors.initials: SN
authors.lastname: Blair
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002423:Cause of Death; D015331:Cohort Studies; D015444:Exercise / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D015996:Survival Rate; D013781:Texas / Q000453:epidemiology