Muscular strength and cardiorespiratory fitness have independent and joint inverse associations with metabolic syndrome prevalence.

Coronary artery calcium (CAC), a measure of subclinical coronary heart disease (CHD), may be useful in identifying asymptomatic persons at risk of CHD events. The current study included 10,746 adults who were 22-96 years of age, were free of known CHD, and had their CAC quantified by electron-beam tomography at baseline as part of a preventive medical examination at the Cooper Clinic (Dallas, Texas) during 1995-2000. During a mean follow-up of 3.5 years, 81 hard events (CHD death, nonfatal myocardial infarction) and 287 total events (hard events plus coronary revascularization) occurred. Age-adjusted rates (per 1,000 person-years) of hard events were computed according to four CAC categories: no detectable CAC and incremental sex-specific thirds of detectable CAC; these rates were, respectively, 0.4, 1.5, 4.8, and 8.7 (trend p<0.0001) for men and 0.7, 2.3, 3.1, and 6.3 (trend p=0.02) for women. CAC levels also were positively associated with rates of total CHD events for women and men (trend p<0.0001 each). The association between CAC and CHD events remained significant after adjustment for CHD risk factors. CAC was associated with CHD events in persons with no baseline CHD risk factors and in younger (aged <40 years) and older (aged >65 years) study participants. These findings show that CAC is associated with an increased risk of CHD events in asymptomatic women and men.

We demonstrated a significant relation between physical activity during a 14-year period and current functional status in older women, thus suggesting that physical activity plays a role in maintaining functional ability later in life.

The authors examined the association between cardiorespiratory fitness and incident hypertension in women who were normotensive and free of cardiovascular disease at baseline in the Aerobics Center Longitudinal Study (Dallas, Texas), 1970-1998. A total of 4,884 women performed a maximal treadmill exercise test and completed a follow-up health survey. During an average follow-up of 5 years, 157 incident cases of self-reported, physician-diagnosed hypertension were identified from the health surveys. The cumulative incidence of hypertension was 3.2%. Compared with the rates of low-fit women, crude hypertension rates were 60% and 79% lower among women in the moderate and high fitness categories, respectively (p < 0.001). After adjustment for several potential confounders, the odds ratios for hypertension were 1.0, 0.61 (95% confidence interval (CI): 0.30, 1.21), and 0.35 (95% CI: 0.17, 0.73) in low-, moderately, and highly fit women, respectively (p(trend) < 0.01). Each 1-metabolic equivalent increment in treadmill performance was, on average, associated with a 19% (95% CI: 10, 27; p < 0.001) lower odds of incident hypertension. The pattern and strength of association between fitness and hypertension persisted in analyses stratified on body mass index, age, and the presence of prehypertension at baseline. An active lifestyle should be promoted for the primary prevention of hypertension in women.

Background:The beneficial effects of cardiorespiratory fitness on mortality are well known; however, the relation of muscular fitness, specifically muscular strength and endurance, to mortality risk has not been thoroughly examined. The purpose of the current study is to determine if a dose-response relation exists between muscular fitness and mortality after controlling for factors such as age and cardiorespiratory fitness. Methods: The study included 9105 men and women, 20-82 years of age, in the Aerobics Center Longitudinal Study who have completed at least one medical examination at the Cooper Clinic in Dallas, TX between 1981 and 1989. The exam included a muscular fitness assessment, based on 1-min sit-up and 1-repetition maximal leg and bench press scores, and a maximal treadmill test. We conducted mortality follow-up through 1996 primarily using the National Death Index, with a total follow-up of 106,046 person-years. All-cause mortality rates were examined across low, moderate, and high muscular fitness strata. Results: Mortality was confirmed in 194 of 9105 participants (2.1%). The age-and sex-adjusted mortality rate of those in the lowest muscular fitness category was higher than that of those in the moderate fitness category (26.8 vs. 15.3 per 10,000 person-years, respectively). Those in the high fitness category had a mortality rate of 20.6 per 10,000 person-years. The moderate and high muscular fitness groups had relative risks of 0.64 (95%CI = 0.44-0.93) and 0.80 (95%CI = 0.49-1.31), adjusting for age, health status, body mass index, cigarette smoking, and cardiorespiratory fitness when compared with the low muscular fitness group. Conclusions: Mortality rates were lower for individuals with moderate/high muscular fitness compared to individuals with low muscular fitness. These findings warrant further research to confirm the apparent threshold effect between low and moderate/high muscular fitness and all-cause mortality.