Fitness and Mortality Among Persons 70 Years and Older Across the Spectrum of Cardiovascular Disease Risk Factor Burden: The FIT Project

Authors

Seamus P. Whelton
Paul A. McAuley
Zeina Dardari
Olusola A. Orimoloye
Erin D. Michos
Clinton A. Brawner, Henry Ford HealthFollow
Jonathan K. Ehrman, Henry Ford HealthFollow
Steven J. Keteyian, Henry Ford HealthFollow
Michael J. Blaha
Mouaz H. Al-Mallah

Recommended Citation

Whelton SP, McAuley PA, Dardari Z, Orimoloye OA, Michos ED, Brawner CA, Ehrman JK, Keteyian SJ, Blaha MJ, and Al-Mallah MH. Fitness and Mortality Among Persons 70 Years and Older Across the Spectrum of Cardiovascular Disease Risk Factor Burden: The FIT Project. Mayo Clin Proc 2021.

Document Type

Article

Publication Date

9-1-2021

Publication Title

Mayo Clinic proceedings. Mayo Clinic

Abstract

OBJECTIVE: To determine whether fitness could improve mortality risk stratification among older adults compared with cardiovascular disease (CVD) risk factors.

METHODS: We examined 6509 patients 70 years of age and older without CVD from the Henry Ford ExercIse Testing Project (FIT Project) cohort. Patients performed a physician-referred treadmill stress test between 1991 and 2009. Traditional categorical CVD risk factors (hypertension, hyperlipidemia, diabetes, and smoking) were summed from 0 to 3 or more. Fitness was grouped as low, moderate, and high (<6, 6 to 9.9, and ≥10 metabolic equivalents of task). All-cause mortality was ascertained through US Social Security Death Master files. We calculated age-adjusted mortality rates, multivariable adjusted Cox proportional hazards, and Kaplan-Meier survival models.

RESULTS: Patients had a mean age of 75±4 years, and 3385 (52%) were women; during a mean follow-up of 9.4 years, there were 2526 deaths. A higher fitness level (P<.001), not lower CVD risk factor burden (P=.31), was associated with longer survival. The age-adjusted mortality rate per 1000 person-years was 56.7 for patients with low fitness and 0 risk factors compared with 24.9 for high fitness and 3 or more risk factors. Among patients with 3 or more risk factors, the adjusted mortality hazard was 0.68 (95% CI, 0.61 to 0.76) for moderate and 0.51 (95% CI, 0.44 to 0.60) for high fitness compared with the least fit.

CONCLUSION: Among persons aged 70 years and older, there was no significant difference in survival of patients with 0 vs 3 or more risk factors, but a higher fitness level identified older persons with good long-term survival regardless of CVD risk factor burden.

PubMed ID

34366139

ePublication

ePub ahead of print

Volume

96

Issue

9

First Page

2376

Last Page

2385