The association between physical fitness and diagnosed chronic disease in health maintenance organization members

PURPOSE: The purpose of this investigation was to determine the relationship between predicted cardiorespiratory fitness (predicted VO2max) and diagnosed chronic disease. DESIGN: A stratified random sample of individuals was surveyed. SETTING: Large Health Maintenance Organization (HMO) in the upper Midwest. SUBJECTS: HMO members (N = 8000), age 40 and over, with none, one, or two or more of the following diagnosed chronic conditions: hypertension, diabetes, dyslipidemia, and heart disease. MEASURES: Predicted VO2max was estimated for those respondents who completed the survey providing all critical data elements (n = 4121; representing 51.5% of total sample). Predicted VO2max was compared across chronic conditions using analysis of variance. The proportion of subjects across fitness quintiles by number of chronic conditions was tested using the chi 2 test. RESULTS: Subjects without chronic conditions showed higher predicted VO2max values (29.8 +/- 7.7 ml/kg/min) than those with one (25.9 +/- 7.8 ml/kg/min) or two or more conditions (25.7 +/- 7.9 ml/kg/min) (p < .0001). Subjects with diabetes, hypertension, and heart disease reported lower predicted VO2max than their healthier counterparts (p < .0001), but this was not the case for dyslipidemia subjects (27.6 +/- 7.6 vs. 27.4 +/- 8.2 ml/kg/min, respectively; p > .58). A larger proportion of diseased subjects was in the lowest fitness quintile for diabetes, hypertension, and heart disease, but not for dyslipidemia. CONCLUSIONS: As a group, chronic disease patients appear to have lower levels of physical fitness than subjects without chronic disease. Physical fitness improvement in diseased populations should be supported in the clinical setting.