Cardiorespiratory fitness, all-cause mortality, and risk of cardiovascular disease in Trinidadian men--the St James survey

Int J Epidemiol. 2005 Dec;34(6):1387-94. doi: 10.1093/ije/dyi193. Epub 2005 Sep 16.


Background: This study examined whether cardiorespiratory fitness is a risk factor for cardiovascular disease, myocardial infarction, and all-cause mortality in a low- to middle-income Trinidadian community of African, South Asian Indian, and European origin. Those of Indian descent have a distinctively high rate of myocardial infarction.

Methods: The St James Study is a prospective total community survey located in Port-of-Spain, Trinidad, West Indies. A random sample of 626 men aged 35-69 years, without angina of effort, previous myocardial infarction, partial or complete atrio-ventricular conduction defect, complete heart block, or exercise-induced asthma, was used for the assessment of cardiorespiratory fitness by cycle ergometry. Surveillance for morbidity and mortality was maintained for an average of 7.3 years.

Results: When the subjects were grouped into those with an age- and fat-free mass-adjusted peak oxygen uptake above and below the mean of 60.4 mmol/min (1.34 l/min), the hazard ratios (below/above) (95% confidence interval) for all-cause mortality, cardiovascular disease incidence, and incidence of myocardial infarction, after allowance for conventional cardiovascular risk factors, were 2.08 (1.23-3.52), 2.13 (1.22-3.69), and 2.36 (0.84-6.67), respectively. For those unable to achieve a level of work requiring an oxygen uptake of 67 mmol/min (1.5 l/min) during progressive exercise, the respective hazard ratios were 3.49 (1.57-7.76), 2.29 (1.21-4.33), and 5.45 (1.22-24.34). Indian ethnicity remained a predictor of myocardial infarction after allowance for cardiorespiratory performance.

Conclusion: Low cardiorespiratory fitness is a risk factor for cardiovascular disease morbidity and mortality in the low- to middle-income developing community of Trinidad.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • African Continental Ancestry Group / statistics & numerical data
  • Aged
  • Anthropometry
  • Blood Pressure
  • Cardiovascular Diseases / ethnology*
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / physiopathology
  • Cause of Death*
  • Diabetic Angiopathies / ethnology
  • Diabetic Angiopathies / physiopathology
  • Electrocardiography
  • European Continental Ancestry Group / statistics & numerical data
  • Exercise Test / methods
  • Health Surveys
  • Humans
  • India / ethnology
  • Male
  • Middle Aged
  • Myocardial Infarction / ethnology
  • Myocardial Infarction / etiology
  • Myocardial Infarction / physiopathology
  • Oxygen Consumption
  • Physical Fitness*
  • Risk Factors
  • Trinidad and Tobago / epidemiology