title: Low aerobic capacity in middle-aged men associated with increased mortality rates during 45 years of follow-up.
abstract: Low aerobic capacity has been associated with increased mortality in short-term studies. The aim of this study was to evaluate the predictive power of aerobic capacity for mortality in middle-aged men during 45-years of follow-up.
  
  
  
  The study design was a population-based prospective cohort study.
  
  
  
  A representative sample from Gothenburg of men born in 1913 was followed from 50-99 years of age, with periodic medical examinations and data from the National Hospital Discharge and Cause of Death registers. At 54 years of age, 792 men performed an ergometer exercise test, with 656 (83%) performing the maximum exercise test.
  
  
  
  In Cox regression analysis, low predicted peak oxygen uptake ([Formula: see text]), smoking, high serum cholesterol and high mean arterial blood pressure at rest were significantly associated with mortality. In multivariable analysis, an association was found between predicted [Formula: see text] tertiles and mortality, independent of established risk factors. Hazard ratios were 0.79 (95% confidence interval (CI) 0.71-0.89; p < 0.0001) for predicted [Formula: see text], 1.01 (1.002-1.02; p < 0.01) for mean arterial blood pressure, 1.13 (1.04-1.22; p < 0.005) for cholesterol, and 1.58 (1.34-1.85; p < 0.0001) for smoking. The variable impact (Wald's χ(2)) of predicted [Formula: see text] tertiles (15.3) on mortality was secondary only to smoking (31.4). The risk associated with low predicted [Formula: see text] was evident throughout four decades of follow-up.
  
  
  
  In this representative population sample of middle-aged men, low aerobic capacity was associated with increased mortality rates, independent of traditional risk factors, including smoking, blood pressure and serum cholesterol, during more than 40 years of follow-up.
authors.affiliation: Department of Molecular and Clinical Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden per.ladenvall@gu.se.
authors.forename: Per
authors.initials: P
authors.lastname: Ladenvall
authors.affiliation: Department of Clinical Neuroscience and Rehabilitation, Sahlgrenska Academy at University of Gothenburg, Sweden.
authors.forename: Carina U
authors.initials: CU
authors.lastname: Persson
authors.affiliation: Department of Molecular and Clinical Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden.
authors.forename: Zacharias
authors.initials: Z
authors.lastname: Mandalenakis
authors.affiliation: Department of Molecular and Clinical Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Wilhelmsen
authors.affiliation: Department of Clinical Neuroscience and Rehabilitation, Sahlgrenska Academy at University of Gothenburg, Sweden.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Grimby
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Sweden.
authors.forename: Kurt
authors.initials: K
authors.lastname: Svärdsudd
authors.affiliation: Department of Molecular and Clinical Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden.
authors.forename: Per-Olof
authors.initials: PO
authors.lastname: Hansson
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death / Q000639:trends; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000401:mortality / Q000503:physiopathology*; D010101:Oxygen Consumption; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013548:Sweden / Q000453:epidemiology
keywords: Exercise testing; aerobic capacity; epidemiology; exercise capacity; mortality