title: Sex Differences in Cardiorespiratory Fitness and All-Cause Mortality: The Henry Ford ExercIse Testing (FIT) Project.
abstract: To determine whether sex modifies the relationship between fitness and mortality.
  
  
  
  We included 57,284 patients without coronary artery disease or heart failure who completed a routine treadmill exercise test between 1991 and 2009. We determined metabolic equivalent tasks (METs) and linked patient records with mortality data via the Social Security Death Index. Multivariable Cox regression was used to determine the association between sex, fitness, and all-cause mortality.
  
  
  
  There were 29,470 men (51.4%) and 27,814 women (48.6%) with mean ages of 53 and 54 years, respectively. Overall, men achieved 1.7 METs higher than women (P<.001). During median follow-up of 10 years, there were 6402 deaths. The mortality rate for men in each MET group was similar to that for women, who achieved an average of 2.6 METs lower (P=.004). Fitness was inversely associated with mortality in both men (hazard ratio [HR], 0.84 per 1 MET; 95% CI, 0.83-0.85) and women (HR, 0.83 per 1 MET; 95% CI, 0.81-0.84). This relationship did not plateau at high or low MET values.
  
  
  
  Although men demonstrated 1.7 METs higher than women, their survival was equivalent to that of women demonstrating 2.6 METs lower. Furthermore, higher MET values were associated with lower mortality for both men and women across the range of MET values. These findings are useful for tailoring prognostic information and lifestyle guidance to men and women undergoing stress testing.
authors.affiliation: Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI; King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Cardiac Center, Ministry of National Guard, Health Affairs, Riyadh, Saudi Arabia. Electronic address: mouaz74@gmail.com.
authors.forename: Mouaz H
authors.initials: MH
authors.lastname: Al-Mallah
authors.affiliation: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Juraschek
authors.affiliation: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD.
authors.forename: Seamus
authors.initials: S
authors.lastname: Whelton
authors.affiliation: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD.
authors.forename: Zeina A
authors.initials: ZA
authors.lastname: Dardari
authors.affiliation: Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI.
authors.forename: Jonathan K
authors.initials: JK
authors.lastname: Ehrman
authors.affiliation: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD.
authors.forename: Erin D
authors.initials: ED
authors.lastname: Michos
authors.affiliation: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD.
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
authors.affiliation: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD.
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
authors.affiliation: Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC.
authors.forename: Waqas T
authors.initials: WT
authors.lastname: Qureshi
authors.affiliation: Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI.
authors.forename: Clinton A
authors.initials: CA
authors.lastname: Brawner
authors.affiliation: Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Keteyian
authors.affiliation: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Blaha
mesh_terms: D000072599:Cardiorespiratory Fitness / Q000502:physiology*; D002423:Cause of Death; D003324:Coronary Artery Disease / Q000401:mortality / Q000503:physiopathology*; D005080:Exercise Test / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D008297:Male; D055686:Metabolic Equivalent / Q000502:physiology; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution