Better cardiorespiratory fitness leads to longer life

Exercise does pay off.  In a paper published in the Journal of the American Medical Association Network Open, Cleveland Clinic researchers have found that better cardiorespiratory fitness leads to longer life, with no limit to the benefit of aerobic fitness.  In the case of elite performers, the researchers have found that the elite performers had an 80% reduction in mortality risk when compared to lower performers.  

The researchers studied 122,007 patients who underwent exercise treadmill testing over s span of two decades, to measure all-cause mortality relating to the benefits of exercise and fitness.  All patients had previously undergone stress tests, and were broken up into five performance groups — elite, high, above average, below average and low.  Elite performers were defined as having aerobic fitness in the top two and half percent by age and gender, and demonstrated fitness levels comparable to endurance athletes.

The study found that increased cardiorespiratory fitness was directly associated with reduced long-term mortality, with no limit on the positive effects of aerobic fitness. Extreme aerobic fitness was associated with the greatest benefit, particularly in older patients (70 and older) and in those with hypertension.  Researcher noted that there is no limit to how much exercise is too much.  Extreme fitness provided additional survival benefit over more modest levels of fitness, and that extremely fit patients lived the longest.

When the subgroups were analyzed by age, the survival benefit of elite versus high performance was most notable in older patients. In those over the age of 70, elite performers had a nearly 30% reduced risk of mortality compared to high performers. In younger age groups there was no statistical difference in outcomes between elite and high performers.

When the subgroups were analyzed by comorbidities, all-cause mortality inversely related to cardiorespiratory fitness and was lowest in the elite performers. For those patients with hypertension, the elite performers again showed a nearly 30% reduction in all-cause mortality compared to high performers. For all other comorbidity subgroups there was no statistical difference in survival rates between the elite and high performers.

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Journal Reference:

Kyle Mandsager, Serge Harb, Paul Cremer, Dermot Phelan, Steven E. Nissen, Wael Jaber. Association of Cardiorespiratory Fitness With Long-term Mortality Among Adults Undergoing Exercise Treadmill TestingJAMA Network Open, 2018; 1 (6): e183605 DOI: 10.1001/jamanetworkopen.2018.3605