title: Exercise capacity and mortality - a follow-up study of 3033 subjects referred to clinical exercise testing.
abstract: Exercise stress testing is used as a diagnostic and prognostic tool. We determined the prognostic significance of exercise test findings for cardiovascular (CVD) and all-cause mortality in men and women.
  
  
  
  3033 subjects underwent a symptom-limited bicycle exercise test. Exercise capacity was defined as the mean of last four minutes of exercise workload.
  
  
  
  During an average follow-up of 19 years, 186 (11.6%) CVD and 370 (20.6%) all-cause deaths in men and 57 (5.0%) CVD and 155 (12.5%) all-cause deaths in women occurred. Among exercise test variables (workload, ECG, BP, HR), exercise capacity was the strongest predictor of mortality. Low exercise capacity (1st quartile) was associated with a hazard ratio of 4.2 (95% CI: 1.7, 10.8) for CVD and 4.0 (95% CI: 2.5, 6.4) for all-cause mortality compared with high exercise capacity (4th quartile) among men and in women with a 5.4-fold (95% CI: 1.2, 24.0) risk for CVD and 2.3-fold (95% CI: 1.2, 4.3) risk for all-cause mortality, respectively. The relationship between other exercise test variables and mortality was much weaker.
  
  
  
  Among exercise test variables exercise capacity was the strongest predictor of CVD and all-cause mortality in both genders, and especially CVD deaths in women. Key Messages Exercise capacity was the most powerful predictor of CVD and all-cause mortality in both men and women. Low exercise capacity is a strong predictor of CVD death, especially among women.
authors.affiliation: a Department of Sports and Exercise Medicine , Oulu Deaconess Institute , Oulu , Finland ;|b Medical Research Center Oulu , University Hospital of Oulu and University of Oulu , Oulu , Finland ;|c Center for Life Course Health Research , University of Oulu , Oulu , Finland ;
authors.forename: Raija
authors.initials: R
authors.lastname: Korpelainen
authors.affiliation: a Department of Sports and Exercise Medicine , Oulu Deaconess Institute , Oulu , Finland ;
authors.forename: Jenni
authors.initials: J
authors.lastname: Lämsä
authors.affiliation: a Department of Sports and Exercise Medicine , Oulu Deaconess Institute , Oulu , Finland ;
authors.forename: Kaisu M
authors.initials: KM
authors.lastname: Kaikkonen
authors.affiliation: b Medical Research Center Oulu , University Hospital of Oulu and University of Oulu , Oulu , Finland ;|d Oulu University Hospital , OYS, Oulu , Finland ;
authors.forename: Juha
authors.initials: J
authors.lastname: Korpelainen
authors.affiliation: e Institute of Public Health and Clinical Nutrition, University of Eastern Finland , Kuopio , Finland ;
authors.forename: Jari
authors.initials: J
authors.lastname: Laukkanen
authors.affiliation: a Department of Sports and Exercise Medicine , Oulu Deaconess Institute , Oulu , Finland ;
authors.forename: Ilkka
authors.initials: I
authors.lastname: Palatsi
authors.affiliation: a Department of Sports and Exercise Medicine , Oulu Deaconess Institute , Oulu , Finland ;
authors.forename: Timo E
authors.initials: TE
authors.lastname: Takala
authors.affiliation: b Medical Research Center Oulu , University Hospital of Oulu and University of Oulu , Oulu , Finland ;|f Center for Environmental and Respiratory Health Research, University of Oulu , Oulu , Finland ;
authors.forename: Tiina M
authors.initials: TM
authors.lastname: Ikäheimo
authors.affiliation: g Center for Machine Vision and Signal Analysis , University of Oulu , Oulu , Finland , University of Oulu.
authors.forename: Arto J
authors.initials: AJ
authors.lastname: Hautala
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000503:physiopathology*; D002423:Cause of Death; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D055815:Young Adult
keywords: Exercise; exercise test; men; mortality; physical fitness; prevention & control; women