Moderate to High Levels of Cardiorespiratory Fitness Attenuate the Effects of Triglyceride to High-Density Lipoprotein Cholesterol Ratio on Coronary Heart Disease Mortality in Men

Mayo Clin Proc. 2017 Dec;92(12):1763-1771. doi: 10.1016/j.mayocp.2017.08.015. Epub 2017 Nov 17.


Objective: To examine the prospective relationships among cardiorespiratory fitness (CRF), fasting blood triglyceride to high density lipoprotein cholesterol ratio (TG:HDL-C), and coronary heart disease (CHD) mortality in men.

Methods: A total of 40,269 men received a comprehensive baseline clinical examination between January 1, 1978, and December 31, 2010. Their CRF was determined from a maximal treadmill exercise test. Participants were divided into CRF categories of low, moderate, and high fit by age group and by TG:HDL-C quartiles. Hazard ratios for CHD mortality were computed using Cox regression analysis.

Results: A total of 556 deaths due to CHD occurred during a mean ± SD of 16.6±9.7 years (669,678 man-years) of follow-up. A significant positive trend in adjusted CHD mortality was shown across decreasing CRF categories (P for trend<.01). Adjusted hazard ratios were significantly higher across increasing TG:HDL-C quartiles as well (P for trend<.01). When grouped by CRF category and TG:HDL-C quartile, there was a significant positive trend (P=.04) in CHD mortality across decreasing CRF categories in each TG:HDL-C quartile.

Conclusion: Both CRF and TG:HDL-C are significantly associated with CHD mortality in men. The risk of CHD mortality in each TG:HDL-C quartile was significantly attenuated in men with moderate to high CRF compared with men with low CRF. These results suggest that assessment of CRF and TG:HDL-C should be included for routine CHD mortality risk assessment and risk management.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Body Mass Index
  • Cardiorespiratory Fitness / physiology*
  • Cholesterol, HDL / blood*
  • Coronary Disease / blood
  • Coronary Disease / mortality*
  • Exercise Test
  • Humans
  • Lipoproteins, HDL / blood
  • Male
  • Middle Aged
  • Physical Fitness*
  • Prognosis
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Triglycerides / blood*


  • Cholesterol, HDL
  • Lipoproteins, HDL
  • Triglycerides