Cardiorespiratory fitness attenuates the effects of the metabolic syndrome on all-cause and cardiovascular disease mortality in men

Arch Intern Med. 2004 May 24;164(10):1092-7. doi: 10.1001/archinte.164.10.1092.


Background: The metabolic syndrome is a prevalent condition that carries with it an increased risk of type 2 diabetes mellitus, cardiovascular disease (CVD), and mortality.

Objective: To determine the relationship between cardiorespiratory fitness (CRF) and mortality in healthy men and in those with the metabolic syndrome.

Methods: The sample included 19 223 men, aged 20 to 83 years, who received a clinical evaluation between 1979 and 1995 with mortality follow-up through December 31, 1996. There were 15 466 healthy men (80.5%) and 3757 men with the metabolic syndrome (19.5%).

Results: A total of 480 deaths (161 due to CVD) occurred during 196 298 man-years of follow-up. After adjustment for age, year of examination, smoking status, alcohol consumption, and parental CVD, the relative risks (RRs) (95% confidence interval) of all-cause and CVD mortality were 1.29 (1.05-1.57) and 1.89 (1.36-2.60), respectively, for men with the metabolic syndrome compared with healthy men. After the inclusion of CRF, the associations were not significant. The RRs comparing unfit with fit men for all-cause mortality were 2.18 (1.66-2.87) in healthy men and 2.01 (1.38-2.93) in men with the metabolic syndrome, whereas the RRs for CVD mortality for unfit vs fit men were 3.21 (2.03-5.07) in healthy men and 2.25 (1.27-3.97) in men with the metabolic syndrome. A significant dose-response relationship between CRF and mortality was also observed in men with the metabolic syndrome.

Conclusion: In this sample, CRF provided a strong protective effect against all-cause and CVD mortality in healthy men and men with the metabolic syndrome.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alcohol Drinking
  • Body Mass Index
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / mortality*
  • Cardiovascular System
  • Case-Control Studies
  • Cause of Death*
  • Cohort Studies
  • Humans
  • Male
  • Metabolic Syndrome / diagnosis
  • Metabolic Syndrome / mortality*
  • Middle Aged
  • Physical Fitness / physiology*
  • Prognosis
  • Risk Assessment
  • Smoking / adverse effects
  • Survival Analysis