Coronary risk factors and incidence of coronary death in relation to physical fitness. Seven-year follow-up study of middle-aged and elderly men

Physical fitness was assessed in relation to a near maximalbicycle exercise test in two populations; population 1: 122middle aged and elderly cross-country skiers with a documentedvery high physical performance, and population 2: 2014 apparentlyhealthy men 40–59 years of age. All were without knownor suspected heart disease at the baseline study. A number ofso-called coronary risk factors were studied simultaneously.The total incidence of coronary heart disease (CHD) events werenoted as was the total 7 year incidence of death from CHD amongmen from population 2. By subdividing the latter in quartilesof physical fitness within each 5 year age group—and studyinglevels of coronary risk factors and CHD deaths within these16 subgroups—the following findings were made: All coronaryrisk factors were favourably and strongly associated with highphysical fitness and vice versa in consistent way. Death frommyocardial infarction and sudden, unexpected death followedthe same pattern in an inverse way. The skiers as a group closelyfollowed the most fit men from population 2 in all respects.Thus we have noted a strong, graded, positive association betweenphysical fitness and a number of coronary risk factors, andan inverse relationship between high physical fitness and therisk of dying from CHD. These findings hold true for a periodof 7 years among middle aged men free fromknown orsuspectedheart disease.