Cardiorespiratory Fitness Change and Mortality Risk Among Black and White Patients: Henry Ford Exercise Testing (FIT) Project.
Little is known about the relationship of change in cardiorespiratory fitness and mortality risk in Black patients. This study assessed change in cardiorespiratory fitness and its association with all-cause mortality risk in Black and White patients.



This is a retrospective, longitudinal, observational cohort study of 13,345 patients (age = 55 ± 11 years; 39% women; 26% black) who completed 2 exercise tests, at least 12 months apart at Henry Ford Hospital, Detroit, Mich. All-cause mortality was identified through April 2013. Data were analyzed in 2015-2016 using Cox regression to calculate hazard ratios (HR) for risk of mortality associated with change in sex-specific cardiorespiratory fitness.



Mean time between the tests was 3.4 years (interquartile range 1.9-5.6 years). During 9.1 years (interquartile range 6.3-11.6 years) of follow-up, there were 1931 (14%) deaths (16.5% black, 13.7% white). For both races, change in fitness from Low to the Intermediate/High category resulted in a significant reduction of death risk (HR 0.65 [95% confidence interval (CI), 0.49-0.87] for Black; HR 0.41 [95% CI, 0.34-0.51] for White). Each 1-metabolic-equivalent-of-task increase was associated with a reduced mortality risk in black (HR 0.84 [95% CI, 0.81-0.89]) and white (HR 0.87 [95% CI, 0.82-0.86]) patients. There was no interaction by race.



Among black and white patients, change in cardiorespiratory fitness from Low to Intermediate/High fitness was associated with a 35% and 59% lower risk of all-cause mortality, respectively.
Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Mich. Electronic address: jehrman1@hfhs.org.
Jonathan K
JK
Ehrman
Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Mich.
Clinton A
CA
Brawner
Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Mich; King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdul-Aziz Cardiac Center, King Abdul-Aziz Medical City, Riyadh, Saudi Arabia.
Mouaz H
MH
Al-Mallah
Department of Cardiology, Wake Forest University, Winston-Salem, NC.
Waqas T
WT
Qureshi
Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins Medicine, Baltimore, Md.
Michael J
MJ
Blaha
Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Mich.
Steven J
SJ
Keteyian
D044383:Black People / Q000706:statistics & numerical data*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010809:Physical Fitness; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D044465:White People / Q000706:statistics & numerical data*
Change; Longitudinal; METs; Metabolic equivalent of task; Retrospective