Influences of Cardiorespiratory Fitness and Other Precursors on Cardiovascular Disease and All-Cause Mortality in Men and Women

Blair, Steven N.; Kampert, James B.; Kohl, Harold W.; Barlow, Carolyn E.; Macera, Caroline A.; Paffenbarger, Ralph S.; Gibbons, Larry W.

doi:10.1001/jama.1996.03540030039029

Cited by 1,534 publications

(594 citation statements)

References 14 publications

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“…The findings of an increased risk for CVD mortality from high OPA and low cardiorespiratory fitness respectively are in accordance with previous studies on CVD, ischemic disease or mortality (7,(15)(16)(17)(18)19), and support the importance of these two factors for cardiovascular health. Moreover, in according with previous studies (3, 6, 7), we found a significant almost three times increased risk for CVD mortality from high OPA among those with low self-reported cardiorespiratory fitness.…”

Section: Discussionsupporting

confidence: 91%

Self-reported occupational physical activity and cardiorespiratory fitness: Importance for cardiovascular disease and all-cause mortality

Holtermann

Marott

Gyntelberg

et al. 2016

Scand J Work Environ Health

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Workers with high occupational physical activity and low cardiorespiratory fitness were found to have a strong excessive risk for CVD mortality. This supports the classic, but scarcely documented thesis in occupational medicine, of the importance of cardiorespiratory fitness for tolerating high physical work demands. Preventive measures for reducing excessive cardiovascular work strain and CVD risk are needed.Affiliation:

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Section: Discussionsupporting

confidence: 91%

Self-reported occupational physical activity and cardiorespiratory fitness: Importance for cardiovascular disease and all-cause mortality

Holtermann

Marott

Gyntelberg

et al. 2016

Scand J Work Environ Health

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“…In relevant prospective studies, CRF has been inversely associated with an increased risk of all-cause and cardiovascular disease mortality (3,19,28). Indeed, CRF has an independent inverse association with MetS in adults (26).…”

Section: Discussionmentioning

confidence: 99%

The role of physical activity and fitness on the metabolic syndrome in adolescents: effect of different scores. The AFINOS Study

Martínez‐Gómez

Eisenmann²,

Moya

et al. 2009

J Physiol Biochem

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“…1 There is growing evidence of an association between regular PA and a reduced risk of all-cause mortality, 2 and of the potential savings for NHS budgets from exercise promotion for older adults. 3 Sedentary behaviour increases the risk of dependence, falls and fractures.…”

Section: Discussionmentioning

confidence: 99%

Multicentre cluster randomised trial comparing a community group exercise programme and home-based exercise with usual care for people aged 65 years and over in primary care

Iliffe

Kendrick

Morris

et al. 2014

Health Technology Assessment

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BackgroundRegular physical activity (PA) reduces the risk of falls and hip fractures, and mortality from all causes. However, PA levels are low in the older population and previous intervention studies have demonstrated only modest, short-term improvements.ObjectiveTo evaluate the impact of two exercise promotion programmes on PA in people aged ≥ 65 years.DesignThe ProAct65+ study was a pragmatic, three-arm parallel design, cluster randomised controlled trial of class-based exercise [Falls Management Exercise (FaME) programme], home-based exercise [Otago Exercise Programme (OEP)] and usual care among older people (aged ≥ 65 years) in primary care.SettingForty-three UK-based general practices in London and Nottingham/Derby.ParticipantsA total of 1256 people ≥ 65 years were recruited through their general practices to take part in the trial.InterventionsThe FaME programme and OEP. FaME included weekly classes plus home exercises for 24 weeks and encouraged walking. OEP included home exercises supported by peer mentors (PMs) for 24 weeks, and encouraged walking.Main outcome measuresThe primary outcome was the proportion that reported reaching the recommended PA target of 150 minutes of moderate to vigorous physical activity (MVPA) per week, 12 months after cessation of the intervention. Secondary outcomes included functional assessments of balance and falls risk, the incidence of falls, fear of falling, quality of life, social networks and self-efficacy. An economic evaluation including participant and NHS costs was embedded in the clinical trial.ResultsIn total, 20,507 patients from 43 general practices were invited to participate. Expressions of interest were received from 2752 (13%) and 1256 (6%) consented to join the trial; 387 were allocated to the FaME arm, 411 to the OEP arm and 458 to usual care. Primary outcome data were available at 12 months after the end of the intervention period for 830 (66%) of the study participants.The proportions reporting at least 150 minutes of MVPA per week rose between baseline and 12 months after the intervention from 40% to 49% in the FaME arm, from 41% to 43% in the OEP arm and from 37.5% to 38.0% in the usual-care arm. A significantly higher proportion in the FaME arm than in the usual-care arm reported at least 150 minutes of MVPA per week at 12 months after the intervention [adjusted odds ratio (AOR) 1.78, 95% confidence interval (CI) 1.11 to 2.87;p = 0.02]. There was no significant difference in MVPA between OEP and usual care (AOR 1.17, 95% CI 0.72 to 1.92;p = 0.52). Participants in the FaME arm added around 15 minutes of MVPA per day to their baseline physical activity level. In the 12 months after the close of the intervention phase, there was a statistically significant reduction in falls rate in the FaME arm compared with the usual-care arm (incidence rate ratio 0.74, 95% CI 0.55 to 0.99;p = 0.042). Scores on the Physical Activity Scale for the Elderly showed a small but statistically significant benefit for FaME compared with usual care, as did perceptions of benefits from exercise. Balance confidence was significantly improved at 12 months post intervention in both arms compared with the usual-care arm. There were no statistically significant differences between intervention arms and the usual-care arm in other secondary outcomes, including quality-adjusted life-years. FaME is more expensive than OEP delivered with PMs (£269 vs. £88 per participant in London; £218 vs. £117 in Nottingham). The cost per extra person exercising at, or above, target was £1919.64 in London and £1560.21 in Nottingham (mean £1739.93).ConclusionThe FaME intervention increased self-reported PA levels among community-dwelling older adults 12 months after the intervention, and significantly reduced falls. Both the FaME and OEP interventions appeared to be safe, with no significant differences in adverse reactions between study arms.Trial registrationThis trial is registered as ISRCTN43453770.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 18, No. 49. See the NIHR Journals Library website for further project information.

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Influences of Cardiorespiratory Fitness and Other Precursors on Cardiovascular Disease and All-Cause Mortality in Men and Women

Cited by 1,534 publications

References 14 publications

Self-reported occupational physical activity and cardiorespiratory fitness: Importance for cardiovascular disease and all-cause mortality

Self-reported occupational physical activity and cardiorespiratory fitness: Importance for cardiovascular disease and all-cause mortality

The role of physical activity and fitness on the metabolic syndrome in adolescents: effect of different scores. The AFINOS Study

Multicentre cluster randomised trial comparing a community group exercise programme and home-based exercise with usual care for people aged 65 years and over in primary care

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