Fitness Level Found Vital in Men's Death Risk

The fittest may indeed survive the longest, according to new research suggesting that physical fitness is more important in death risk than even high blood pressure, high cholesterol or smoking.

The study of more than 6,200 US men who underwent treadmill testing for cardiovascular disease found that the risk of death over the next 6 years declined as exercise capacity rose. This was true of both men with cardiovascular disease and those whose exercise tests were normal.

Exercise capacity was the best predictor of death risk among men with cardiovascular disease. And among all participants, those in the group with the lowest exercise capacity were about four times more likely to die during the study period compared with the fittest group.

Overall, fitness mattered more in death risk than such classic cardiovascular risk factors as high blood pressure, smoking and body mass index.

For instance, a man who had high blood pressure but was among the fittest was about half as likely to die as a man with high blood pressure and low fitness levels.

Findings like this, the researchers write, "confirm the protective role" of exercise, even in individuals with other health risk factors.

The study also showed the less-fit can improve their survival by becoming more physically active.

Current US guidelines for exercise recommend that all healthy adults take up some moderate physical activity for at least 30 minutes a day on most, and preferably all, days of the week. People with cardiovascular disease should consult their doctors about an appropriate exercise plan.

The New England Journal of Medicine March 14, 2002;346:793-801, 852-853