Exercise >>> Mortality ... Was Re: Exercise >>> Immunity

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> > > > " Each 1-MET increase in exercise capacity conferred a 12

percent

> > > improvement in survival. "

> > > >

> > > >

> > > >

> > > > NEJM

> > > >

> > > > Volume 346:793-801 March 14, 2002 Number 11

> > > >

> > > >

> > > > Exercise Capacity and Mortality among Men Referred for

Exercise

> > > Testing

> > > >

> > > > Myers, Ph.D., Manish Prakash, M.D., Victor

Froelicher,

> > > M.D., Dat Do, M.D., Sara Partington, B.Sc., and J. Edwin

Atwood,

> > M.D.

> > > >

> > > >

> > > > ABSTRACT

> > > >

> > > > Background Exercise capacity is known to be an important

> > prognostic

> > > factor in patients with cardiovascular disease, but it is

uncertain

> > > whether it predicts mortality equally well among healthy

persons.

> > > There is also uncertainty regarding the predictive power of

> > exercise

> > > capacity relative to other clinical and exercise-test

variables.

> > > >

> > > > Methods We studied a total of 6213 consecutive men referred

for

> > > treadmill exercise testing for clinical reasons during a mean

(±SD)

> > > of 6.2±3.7 years of follow-up. Subjects were classified into

two

> > > groups: 3679 had an abnormal exercise-test result or a history

of

> > > cardiovascular disease, or both, and 2534 had a normal exercise-

> > test

> > > result and no history of cardiovascular disease. Overall

mortality

> > > was the end point.

> > > >

> > > > Results There were a total of 1256 deaths during the follow-

up

> > > period, resulting in an average annual mortality of 2.6

percent.

> > Men

> > > who died were older than those who survived and had a lower

maximal

> > > heart rate, lower maximal systolic and diastolic blood

pressure,

> > and

> > > lower exercise capacity. After adjustment for age, the peak

> > exercise

> > > capacity measured in metabolic equivalents (MET) was the

strongest

> > > predictor of the risk of death among both normal subjects and

those

> > > with cardiovascular disease. Absolute peak exercise capacity

was a

> > > stronger predictor of the risk of death than the percentage of

the

> > > age-predicted value achieved, and there was no interaction

between

> > > the use or nonuse of beta-blockade and the predictive power of

> > > exercise capacity. Each 1-MET increase in exercise capacity

> > conferred

> > > a 12 percent improvement in survival.

> > > >

> > > > Conclusions Exercise capacity is a more powerful predictor of

> > > mortality among men than other established risk factors for

> > > cardiovascular disease.