Non-exercise Estimated Cardiorespiratory Fitness and Mortality Among Adults with Hypertension

Yong-Jian Zhu; Wan-Rong Fu; Wen-Jie Lu; Xu-Le Wang; Xi Wang; Ying-Guang Shan; Xiao-Lin Zheng; Ran Li; Meng Peng; Liang Pan; Jing Qiu; Xiao-Fei Qin; Guo-Ju Sun; Lu Wang; Jian-Zeng Dong; Li-Li Xiao; Chun-Guang Qiu

doi:10.1093/ajh/hpae137

Non-exercise Estimated Cardiorespiratory Fitness and Mortality Among Adults with Hypertension

Am J Hypertens. 2024 Oct 13:hpae137. doi: 10.1093/ajh/hpae137. Online ahead of print.

Authors

Yong-Jian Zhu¹, Wan-Rong Fu², Wen-Jie Lu¹, Xu-Le Wang¹, Xi Wang¹, Ying-Guang Shan¹, Xiao-Lin Zheng¹, Ran Li¹, Meng Peng¹, Liang Pan¹, Jing Qiu¹, Xiao-Fei Qin¹, Guo-Ju Sun¹, Lu Wang², Jian-Zeng Dong², Li-Li Xiao¹, Chun-Guang Qiu¹

Affiliations

¹ Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
² Cardiovascular Institute of Zhengzhou University, Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

PMID: 39396103
DOI: 10.1093/ajh/hpae137

Abstract

Background: The non-exercise estimated cardiorespiratory fitness (eCRF) has been recognized as important predictor of mortality among general population. This study sought to evaluate the relationship between eCRF and mortality from all causes, cardiovascular disease (CVD), and cancer in hypertensive adults.

Methods: We included 27437 adults with hypertension from the National Health and Nutrition Examination Survey (NHANES) III and 10 NHANES cycles from 1999-2018. Multivariate Cox proportional hazards models were used to assess the hazard ratios (HRs) and 95% confidence intervals (CIs) of eCRF for mortality.

Results: A total of 8023 deaths were recorded throughout a median 8.6-year follow-up, including 2338 from CVD, and 1761 from cancer. The eCRF with per 1 metabolic equivalent increase was linked to decreased risk of all-cause (adjusted HR 0.78, 95% CI: 0.75-0.81) and CVD mortality (adjusted HR 0.79, 95% CI: 0.74-0.84), rather than cancer mortality (adjusted HR 0.94, 95% CI: 0.86-1.03). Moreover, a stronger protective effect of eCRF was observed for females (HR 0.66 (95% CI: 0.62-0.72) versus HR 0.78 (95% CI: 0.73-0.83), Pinteraction < 0.001 for all-cause mortality; HR 0.70 (95% CI: 0.61-0.80;) versus HR 0.82 (95% CI: 0.73-0.92), Pinteraction = 0.026 for CVD mortality) compared with males. Findings did not significantly differ in subgroup analyses and sensitivity analyses.

Conclusions: Among adults with hypertension, eCRF was inversely related to all-cause and CVD mortality, but not cancer mortality. A significant interaction effect existed between sex and eCRF. Further studies are needed to verify this association in different population.

Keywords: Cardiorespiratory fitness; Cohort; Hypertension; Mortality.

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