Background

Cardiorespiratory fitness (CRF) is inversely associated with all-cause mortality. However, the association of CRF and mortality risk for different races, women, and elderly individuals has not been fully assessed.

Objectives

The aim of this study was to evaluate the association of CRF and mortality risk across the spectra of age, race, and sex.

Methods

A total of 750,302 U.S. veterans aged 30 to 95 years (mean age 61.3 ± 9.8 years) were studied, including septuagenarians (n = 110,637), octogenarians (n = 26,989), African Americans (n = 142,798), Hispanics (n = 35,197), Native Americans (n = 16,050), and women (n = 45,232). Age- and sex-specific CRF categories (quintiles and 98th percentile) were established objectively on the basis of peak METs achieved during a standardized exercise treadmill test. Multivariable Cox models were used to estimate HRs and 95% CIs for mortality across the CRF categories.

Results

During follow-up (median 10.2 years, 7,803,861 person-years of observation), 174,807 subjects died, averaging 22.4 events per 1,000 person-years. The adjusted association of CRF and mortality risk was inverse and graded across the age spectrum, sex, and race. The lowest mortality risk was observed at approximately 14.0 METs for men (HR: 0.24; 95% CI: 0.23-0.25) and women (HR: 0.23; 95% CI: 0.17-0.29), with no evidence of an increase in risk with extremely high CRF. The risk for least fit individuals (20th percentile) was 4-fold higher (HR: 4.09; 95% CI: 3.90-4.20) compared with extremely fit individuals.

Conclusions

The association of CRF and mortality risk across the age spectrum (including septuagenarians and octogenarians), men, women, and all races was inverse, independent, and graded. No increased risk was observed with extreme fitness. Being unfit carried a greater risk than any of the cardiac risk factors examined.

中文翻译：

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不同年龄、种族和性别的心肺健康和死亡率风险

背景

心肺健康 (CRF) 与全因死亡率呈负相关。然而，CRF 与不同种族、女性和老年人的死亡风险之间的关联尚未得到充分评估。

目标

本研究的目的是评估 CRF 与跨年龄、种族和性别范围的死亡风险之间的关联。

方法

共研究了 750,302 名年龄在 30 至 95 岁（平均年龄 61.3 ± 9.8 岁）的美国退伍军人，包括七十多岁的人 (n = 110,637)、八十多岁的人 (n = 26,989)、非裔美国人 (n = 142,798)、西班牙裔人 (n = 35,197) )、美洲原住民 (n = 16,050) 和女性 (n = 45,232)。年龄和性别特定的 CRF 类别（五分位数和第 98 个百分位数）是根据标准化运动跑步机测试期间达到的峰值 MET 客观建立的。多变量Cox 模型用于估计 CRF 类别中死亡率的 HR 和 95% CI。

结果

在随访期间（中位数 10.2 年，7,803,861 人年的观察），174,807 名受试者死亡，平均每 1,000 人年 22.4 起事件。调整后的 CRF 和死亡风险的关联是反向的，并且在年龄范围、性别和种族中分级。男性（HR：0.24；95% CI：0.23-0.25）和女性（HR：0.23；95% CI：0.17-0.29）的死亡率风险最低，约为 14.0 MET，没有证据表明风险增加极高的 CRF。与非常健康的人相比，最不健康的人（第 20 个百分位数）的风险高 4 倍（HR：4.09；95% CI：3.90-4.20）。

结论

CRF 与跨年龄段（包括七十多岁和八十多岁）、男性、女性和所有种族的死亡风险的关联是反向的、独立的和分级的。极端健身没有观察到风险增加。不健康带来的风险比检查的任何心脏风险因素都大。