Association of fitness in young adulthood with survival and cardiovascular risk the coronary artery risk development in young adults (CARDIA) study

Ravi V. Shah, Venkatesh L. Murthy, Laura A. Colangelo, Jared Reis, Bharath Ambale Venkatesh, Ravi Sharma, Siddique A. Abbasi, David C. Goff, J. Jeffrey Carr, Jamal S. Rana, James G. Terry, Claude Bouchard, Mark A. Sarzynski, Aaron Eisman, Tomas Neilan, Saumya Das, Michael Jerosch-Herold, Cora E. Lewis, Mercedes Carnethon, Gregory D. LewisJoao Lima

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Abstract

Importance Although cardiorespiratory fitness (CRF) is prognostic in older adults, the effect of CRF during early adulthood on long-term cardiovascular structure, function, and prognosis is less clear. Objective To examine whether CRF in young adults is associated with long-term clinical outcome and subclinical cardiovascular disease (CVD). Design, Setting, and Participants Prospective study of 4872 US adults aged 18 to 30 years who underwent treadmill exercise testing at a baseline study visit from March 25, 1985, to June 7, 1986, and 2472 individuals who underwent a second treadmill test 7 years later. Median follow-up was 26.9 years, with assessment of obesity, left ventricular mass and strain, coronary artery calcification (CAC), and vital status and incident CVD. Follow-up was complete on August 31, 2011, and data were analyzed from recruitment through the end of follow-up. Main Outcomes and Measures The presence of CACwas assessed by computed tomography at years 15 (2000-2001), 20 (2005-2006), and 25 (2010-2011), and left ventricular mass was assessed at years 5 (1990-1991) and 25 (with global longitudinal strain). Incident CVD and all-cause mortality were adjudicated. Results Of the 4872 individuals, 273 (5.6%) died and 193 (4.0%) experienced CVD events during follow-up. After comprehensive adjustment, each additional minute of baseline exercise test duration was associated with a 15%lower hazard of death (hazard ratio [HR], 0.85; 95%CI, 0.80-0.91; P

Original languageEnglish (US)
Pages (from-to)87-95
Number of pages9
JournalJAMA Internal Medicine
Volume176
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

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ASJC Scopus subject areas

  • Internal Medicine

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