BACKGROUND An inverse association between cardiorespiratory fitness and mortality was robustly demonstrated 3 decades ago. OBJECTIVES The purpose of this study was to determine whether significant advances in disease prevention, detection, and treatment since that time have modified this association. METHODS A total of 47,862 men completed baseline examinations, including a maximal treadmill test. Cohort 1 (n = 24,475) was examined during 1971 to 1991 and followed for mortality through 1992. Cohort 2 (n = 23,387) was examined during 1992 to 2013 with follow-up through 2014. Men were categorized as low fit, moderate fit, or high fit using Cooper Clinic normative data. Hazard ratios (HRs) for all-cause, cardiovascular disease, and cancer mortality were determined across fitness categories in the 2 cohorts. RESULTS A significant inverse trend between fitness categories and all-cause (HR: 1.0, 0.60, and 0.53 in cohort 1 and HR: 1.0, 0.76, and 0.52 in cohort 2) and cardiovascular disease mortality (HR: 1.0, 0.55, and 0.43 in cohort 1 and HR: 1.0, 0.84, and 0.52 in cohort 2) was observed (p trend <0.001 for all). The trend across fitness categories and cancer mortality was significant for cohort 1 (HR: 1.0, 0.62, and 0.48; p < 0.001), but not for cohort 2 (HR: 1.0, 1.08, and 0.74; p = 0.19). HRs for all-cause mortality were 0.86 (95% confidence interval: 0.82 to 0.90) and 0.87 (95% confidence interval: 0.83 to 0.91) per 1-MET increment in fitness for cohorts 1 and 2, respectively (p < 0.001 for both). Similar values were seen for cardiovascular disease and cancer mortality. CONCLUSIONS Despite significant advances in disease prevention, detection, and treatment since fitness was first shown to be associated with mortality, the inverse association between fitness and mortality remains consistent in a contemporary cohort of men.

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接受现代医疗护理的男性健康与死亡风险的相关性

背景 3 年前，心肺适能与死亡率之间的负相关已被有力地证明。目的 本研究的目的是确定自那时以来疾病预防、检测和治疗方面的重大进展是否改变了这种关联。方法 共有 47,862 名男性完成了基线检查，包括最大跑步机测试。队列 1 (n = 24,475) 在 1971 年至 1991 年期间进行了检查，并追踪了 1992 年的死亡率。队列 2 (n = 23,387) 在 1992 年至 2013 年期间进行了检查，随访至 2014 年。男性被归类为低健康、中等健康、或使用 Cooper Clinic 规范数据进行高拟合。全因、心血管疾病和癌症死亡率的风险比 (HR) 是在 2 个队列中跨健身类别确定的。结果 健康类别和全因（HR：1.0、0.60 和 0.53 在队列 1 和 HR：1.0、0.76 和 0.52 在队列 2）和心血管疾病死亡率（HR：1.0、0.55 和 0.43）之间存在显着的反向趋势在队列 1 和 HR：观察到队列 2 中的 1.0、0.84 和 0.52（所有 p 趋势 <0.001）。对于队列 1（HR：1.0、0.62 和 0.48；p < 0.001），健康类别和癌症死亡率的趋势显着，但对于队列 2（HR：1.0、1.08 和 0.74；p = 0.19）则不然。队列 1 和队列 2 的适应性每增加 1-MET，全因死亡率的 HR 分别为 0.86（95% 置信区间：0.82 至 0.90）和 0.87（95% 置信区间：0.83 至 0.91）（p < 0.001） ）。心血管疾病和癌症死亡率也有类似的值。结论 尽管在疾病预防方面取得了重大进展，