Higher fitness levels reduce CVD mortality risk in men with high systolic blood pressure
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Key takeaways:
- Higher fitness levels can reduce risk for death from heart disease in men with high systolic blood pressure.
- High blood pressure was associated with higher CVD mortality risk vs. normal blood pressure.
Higher levels of cardiorespiratory fitness attenuated CVD mortality risk in older and middle-aged men with high systolic BP, researchers reported.
“These findings add to the emerging evidence that achieving and maintaining the highest level of cardiorespiratory fitness during adulthood is important for lowering the risk of chronic disease outcomes as well as death and the most effective way of doing this is through regular and increased physical activity or exercise training,” Jari A. Laukkanen, MD, PhD, professor and head of the department of internal medicine at University of Eastern Finland, and colleagues wrote in the European Journal of Preventive Cardiology.
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To determine the effect of cardiorespiratory fitness levels in the modification of the relationship between systolic BP levels and CVD mortality risk, Laukkanen and colleagues analyzed the fitness levels, BP and CVD mortality incidence from baseline and screening assessments of 2,280 men aged 42 to 61 years (mean age, 53 years) from eastern Finland in the Kuopio Ischemic Heart Disease (KIHD) prospective cohort study. The assessments were carried out between March 1984 and December 1989. The median follow-up period of 28.5 years.
Systolic BP was measured and labeled normal (< 140 mm Hg) or high (> 140 mm Hg), whereas cardiorespiratory fitness was measured via peak oxygen uptake labeled in tertiles.
Study participants were then grouped into the following categories: normal systolic BP/high cardiorespiratory fitness; normal systolic BP/low cardiorespiratory fitness; high systolic BP/high cardiorespiratory fitness; and high systolic BP/low cardiorespiratory fitness.
Laukkanen and colleagues found that, compared with normal systolic BP, high systolic BP was associated with increased risk for CVD mortality (adjusted HR = 1.39; 95% CI, 1.17-1.63; P < .001).
In addition, the bottom tertile of cardiorespiratory fitness levels was associated with increased CVD mortality risk compared with the top tertile (aHR = 1.74; 95% CI, 1.35-2.23; P < .001).
Compared with men who had normal systolic BP/high cardiorespiratory fitness, men who had high systolic BP/low cardiorespiratory fitness had an increased CVD mortality risk (aHR = 2.35; 95% CI, 1.81-3.04; P < .001), whereas men with high systolic BP/high cardiorespiratory fitness had “attenuated but persisting” CVD mortality risk (aHR = 1.55; 95% CI, 1.16-2.07; P = .003).
“The risk of CVD mortality in men with high systolic BP was attenuated in the presence of high cardiorespiratory fitness levels, which is likely due to the strong protective effects of high fitness levels for serious CVD events,” Laukkanen and colleagues wrote. “Large-scale prospective studies are needed to replicate these findings and definitive trials required to provide the highest level of evidence.”
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