The benefits of cardiorespiratory fitness extended well into the later part of life for employed, middle-aged men without cardiovascular disease, and were significantly related to longevity over 4 decades, according to a study published in Journal of the American College of Cardiology.

A team of Danish researchers sought to investigate the associations between cardiorespiratory fitness and very long-term prognosis in a study with 46 years of follow up. Study participants were middle-aged, employed men without cardiovascular disease from the Copenhagen Male Study (N=5107; mean age, 48.8±5.4 years). Participants were stratified into 4 age-adjusted VO2max (maximal oxygen consumption) categories: above upper limit of normal (5%), high normal (45%), low normal (45%), and below lower limit of normal (5%). VO2Max levels were estimated using a bicycle ergometer, and restricted, multivariable, mean survival time models of cardiovascular and all-cause mortality were performed using Danish national registers.

During the 46-year follow-up period, 92% of the men died; 42.1% died of cardiovascular disease. When compared with the lowest VO2Max group, low normal cardiorespiratory fitness was associated with 2.1 years longer life expectancy (95% CI, 0.7-3.4; P =.002), high normal cardiorespiratory fitness with 2.9 years longer life expectancy (95% CI, 1.5-4.2; P <.001), and above upper limit of normal cardiorespiratory fitness with 4.9 years longer life expectancy (95% CI, 3.1-6.7; P <.001). Each unit of increase in VO2Max was associated with 45 days increased longevity (95% CI, 30-61; P <.001), and estimates of cardiovascular vs all-cause mortality were similar. When individuals who died in the first 10 years of follow-up were excluded, the results were essentially unchanged.

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Study investigators conclude that these findings “show that the benefits of higher midlife [cardiorespiratory fitness] extend well into the later part of life. Fitness-enhancing physical activity should be recommended by health care professionals to improve public health and promote healthy aging.”


Clausen JSR, Marott JL, Holtermann A, Gyntelberg F, Jensen, MT. Midlife cardiorespiratory fitness and the long-term risk of mortality: 46 years of follow-up. J Am Coll Cardiol. 2018; 72(9):987-995.