title: Cardiorespiratory Fitness and Risk of Sudden Cardiac Death in Men and Women in the United States: A Prospective Evaluation From the Aerobics Center Longitudinal Study.
abstract: To examine the relation between cardiorespiratory fitness (CRF) and sudden cardiac death (SCD) in a large US adult population and to study the effects of hypertension, obesity, and health status on the relation of CRF with SCD.
  
  
  
  A total of 55,456 individuals (mean age, 44.2 years; 13,507 women) from the Aerobics Center Longitudinal Study, a prospective observational investigation (from January 2, 1974, through December 31, 2002), were included. Cardiorespiratory fitness was assessed by a maximal treadmill test, and baseline assessment included an extensive set of measurements.
  
  
  
  There were 109 SCDs. An inverse risk of SCD was found across incremental CRF levels after adjusting for potential confounders. Participants with moderate and high CRF levels had 44% (hazard ratio, 0.56; 95% CI, 0.35-0.90) and 48% (hazard ratio, 0.52; 95% CI, 0.30-0.92) significantly lower risk of SCD, respectively, than did those with low CRF levels (P<.001). The risk of SCD decreased by 14% (hazard ratio, 0.86; 95% CI, 0.77-0.96) per 1-metabolic equivalent increase in the fully adjusted model. Hypertensive, overweight, or unhealthy individuals with moderate to high CRF levels had lower risks of SCD (ranging from 58% to 72% of lower risk) than did those with the same medical conditions and low CRF levels.
  
  
  
  The risk of SCD in US men and women could be partially reduced by ensuring moderate to high levels of CRF independently of other risk factors and especially in those who are hypertensive, overweight, or unhealthy.
authors.affiliation: GALENO Research Group, Department of Physical Education, University of Cádiz, Puerto Real, Cádiz, Spain; Department of Exercise Science, University of South Carolina, Columbia; GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain. Electronic address: david.jimenez@uca.es.
authors.forename: David
authors.initials: D
authors.lastname: Jiménez-Pavón
authors.affiliation: Department of Exercise Science, University of South Carolina, Columbia; Department of Education, University of Almería, Almería, Spain.
authors.forename: Enrique G
authors.initials: EG
authors.lastname: Artero
authors.affiliation: Department of Kinesiology, Iowa State University, Ames.
authors.forename: Duck-Chul
authors.initials: DC
authors.lastname: Lee
authors.affiliation: GALENO Research Group, Department of Physical Education, University of Cádiz, Puerto Real, Cádiz, Spain; Medical Research Council Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, United Kingdom.
authors.forename: Vanesa
authors.initials: V
authors.lastname: España-Romero
authors.affiliation: Department of Exercise Science, University of South Carolina, Columbia.
authors.forename: Xuemei
authors.initials: X
authors.lastname: Sui
authors.affiliation: Department of Exercise Science, University of South Carolina, Columbia.
authors.forename: Russell R
authors.initials: RR
authors.lastname: Pate
authors.affiliation: Preventive Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA.
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Church
authors.affiliation: GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Moreno
authors.affiliation: Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland's School of Medicine, New Orleans, LA.
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Lavie
authors.affiliation: Department of Exercise Science, University of South Carolina, Columbia; Department of Epidemiology and Biostatistics, University of South Carolina, Columbia.
authors.forename: Steven N
authors.initials: SN
authors.lastname: Blair
mesh_terms: D000328:Adult; D015992:Body Mass Index; D000072599:Cardiorespiratory Fitness / Q000502:physiology*; D002423:Cause of Death; D015897:Comorbidity; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D005080:Exercise Test; D005260:Female; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D055686:Metabolic Equivalent; D009765:Obesity / Q000453:epidemiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013781:Texas / Q000453:epidemiology; D014481:United States / Q000453:epidemiology