Higher Fitness Level Can Determine Longer Lifespan After Age 70

Researchers have uncovered one more reason to get off the couch and start exercising, especially if you’re approaching your golden years. Among people over age 70, physical fitness was found to be a much better predictor of survival than the number of traditional cardiovascular risk factors in a study being presented at the American College of Cardiology’s 68th Annual Scientific Session.

While high blood pressure, high cholesterol, diabetes and smoking are closely linked with a person’s chance of developing heart disease, these factors are so common in older people that the total number of risk factors becomes almost meaningless for predicting future health, researchers said. The new study suggests doctors can get a better picture of older patients’ health by looking at how fit they are, rather than how many of these cardiovascular risk factors they have.

“We found fitness is an extremely strong risk predictor of survival in the older age group—that is, regardless of whether you are otherwise healthy or have cardiovascular risk factors, being more fit means you’re more likely to live longer than someone who is less fit,” said Seamus P. Whelton, MD, MPH, assistant professor of medicine at Johns Hopkins School of Medicine and the study’s lead author. “This finding emphasizes the importance of being fit, even when you’re older.”

Doctors use cardiovascular risk factors to help guide decisions about preventive measures and medications. Previous studies have shown that quitting smoking and controlling blood pressure, cholesterol and diabetes can reduce heart disease risk. However, most studies of cardiovascular risk factors have focused on middle-aged people, leaving a knowledge gap regarding the importance of these risk factors in older people, Whelton said.

The team analyzed medical records from more than 6,500 people aged 70 years and older who underwent an exercise stress test at a Henry Ford Health Systems-affiliated medical center between 1991 and 2009. They assessed fitness based on patients’ performance during the exercise stress test, which required patients to exercise on a treadmill as hard as they could. They divided patients into three groups reflecting their fitness based on the number of METs (metabolic equivalents, a measure of exercise workload) they achieved during the test: most fit (10 or more METs), moderately fit (six to 9.9 METs) and least fit (six or fewer METs). For this study, the researchers grouped patients with zero, one, two, or three or more cardiovascular risk factors.

On average, participants were 75 years old when they underwent the stress test. Researchers tracked the patients for an average of just under 10 years, during which time 39 percent of them died. Over this period, the researchers found higher fitness was associated with significantly increased rates of survival. The most fit individuals were more than twice as likely to be alive 10 years later compared with the least fit individuals.

In contrast, a patient’s total number of cardiovascular risk factors was not associated with their risk of death and patients with zero risk factors had essentially the same likelihood of dying as those with three or more risk factors.

Whelton said the findings demonstrate that fitness level is an important indicator of an older patient’s health that doctors could benefit from considering more often. While an exercise stress test using a treadmill or stationary bicycle provides the most precise way to measure fitness, doctors can also get a general idea of a patient’s fitness level by asking about their exercise routine.

“Assessing fitness is a low-cost, low-risk and low-technology tool that is underutilized in clinical practice for risk stratification,” Whelton said.

The study did not account for any changes in fitness level that the participants may have experienced over time. However, previous studies have suggested that improving fitness can help improve heart health, even late in life.

“People who aren’t exercising or are sedentary would likely benefit from starting a routine of low- to moderate-intensity exercise, though they should talk with their physician first,” Whelton said.

Source: American College of Cardiology


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Women Are Naturally More Fit than Men

When it comes to getting and staying fit, women may have an aerobic edge over men, new research suggests.

In a small new study, investigators compared oxygen uptake and muscle oxygen extraction in 18 young men and women while they worked out on a treadmill. Oxygen uptake is an important measure of aerobic fitness.

Women consistently processed oxygen about 30 percent faster than men, according to researchers at the University of Waterloo in Ontario, Canada.

“The findings are contrary to the popular assumption that men’s bodies are more naturally athletic,” study author Thomas Beltrame said in a university news release.

Another researcher put it this way.

“We found that women’s muscles extract oxygen from the blood faster, which, scientifically speaking, indicates a superior aerobic system,” said Richard Hughson. He is a professor with the faculty of applied health sciences at Waterloo and is also an expert in vascular aging and brain health.

Because women process oxygen faster, women are less likely to accumulate molecules linked with muscle fatigue, effort perception and poor athletic performance, the researchers explained.

The findings were published recently in the journal Applied Physiology, Nutrition, and Metabolism.

“While we don’t know why women have faster oxygen uptake, this study shakes up conventional wisdom,” Beltrame said. “It could change the way we approach assessment and athletic training down the road.”

Source: University of Waterloo


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‘Fat But Fit’ a Myth?

No amount of extra weight is good for your heart, no matter how fit you are by other measures, new British research shows.

“Our findings suggest that if a patient is overweight or obese, all efforts should be made to help them get back to a healthy weight, regardless of other factors,” said study co-author Camille Lassale, from Imperial College London’s School of Public Health.

“Even if their blood pressure, blood sugar and cholesterol appear within the normal range, excess weight is still a risk factor,” Lassale said in a university news release. In fact, the increased risk of developing heart disease was more than 25 percent, the study found.

The study used statistics about the health of people in 10 European countries. Researchers focused on weight and signs of heart disease, when blood vessels become clogged.

The authors looked at more than 7,600 people who had cardiovascular events such as death from heart attack, and compared them to 10,000 people who didn’t have heart problems.

After adjusting their figures so they wouldn’t be thrown off by other lifestyle factors, the researchers found that people with three or more heart risk factors like high blood pressure, high cholesterol or large waist sizes (more than 37 inches for men and 31 inches for women) were more than twice as likely to have heart disease, regardless of whether their weight was normal or above normal.

But those who were considered overweight yet healthy were still 26 percent more likely to develop heart disease than their normal-weight peers. Those considered healthy but obese had a 28 percent higher risk, the study found.

The findings, which don’t prove that extra weight causes heart risks to rise, were published Aug. 14 in the European Heart Journal.

“I think there is no longer this concept of healthy obese,” said study co-author Ioanna Tzoulaki, a senior lecturer in epidemiology at the university.

“If anything, our study shows that people with excess weight who might be classed as ‘healthy’ haven’t yet developed an unhealthy metabolic profile. That comes later in the timeline, then they have an event, such as a heart attack,” she said.

Source: HealthDay


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Lack of Fitness Second Only to Smoking as Predictor of Early Death: Study

Poor physical fitness ranks right behind smoking as leading risk factors for an early death, new long-term research suggests.

Analyzing nearly 800 men starting at midlife, Swedish scientists also found that each measurable increase in fitness levels translated into a 21 percent lower risk of death over 45 years of follow-up.

“Fitness in middle age is of importance for mortality risk for several decades,” said study author Per Ladenvall, a researcher in the department of molecular and clinical medicine at University of Gothenburg. “Persons with low fitness are associated with an increased mortality risk throughout life.”

“Smoking was the risk factor that was [most strongly] associated with mortality,” Ladenvall added. “We were somewhat surprised that the effect of aerobic capacity was even more pronounced than that of high cholesterol and high blood pressure.”

Heart problems caused by narrowed heart arteries, also known as ischemic heart disease, is the most common cause of death worldwide, according to the World Health Organization.

Using exercise testing, which is traditionally used to diagnose ischemic heart disease, the study authors set out to determine the impact of physical fitness on early death from all causes. They also looked at established risk factors of heart disease such as smoking, high cholesterol and high blood pressure.

The new research analyzed 792 men born in 1913 who performed an exercise test in 1967, at 54 years of age. More than 650 of the healthiest men also did an exercise test measuring maximal oxygen uptake, called VO2 max. The higher a person’s VO2 max measurement, the more physically fit they are.

Tracking the men and using information from several physical exams in intervening years, the researchers obtained data on deaths from all causes. To determine the association between predicted VO2 max (physical fitness) and death, study participants were divided into three groups ranging from low to high VO2 max.

Each increase in predicted VO2 max (physical fitness) levels was linked with a 21 percent lower risk of death over 45 years of follow-up, even after adjusting for other risk factors such as smoking, blood pressure and cholesterol levels.

But the study didn’t prove a cause-and-effect link between aerobic fitness and early death risk, just an association.

The findings were published online in the European Journal of Preventive Cardiology.

U.S. cardiologists agreed with Ladenvall that the study’s long follow-up period strengthens the value of the findings.

“The surprising part of the finding is that [physical fitness] is prognostically important so many years down the line,” said Dr. William Zoghbi, chief of cardiology at Houston Methodist Hospital in Texas.

“A message we’ve heard before is that physical fitness is really a major determinant of longevity,” added Zoghbi, past president of the American College of Cardiology. “This study supports it.”

But how much exercise is enough to lower a person’s risk factors for dying earlier?

This question wasn’t addressed in the study, Ladenvall said, “but on a general note, the amount of exercise needed to increase fitness is dependent on the baseline fitness in that individual.”

“In people with low fitness, even small increases in activity levels can have beneficial effects,” he said.

Dr. William Weintraub, chair of cardiology and founding director of the Center for Outcomes Research at Christiana Care Health System in Wilmington, Del., agreed.

“It doesn’t have to be fast, and people don’t have to go out and run marathons,” Weintraub said. “We need to think of something on the order of 30 minutes to an hour a day of activity. Get home from work and go for a walk. There’s evidence that more activity is better up to a point, but any activity is good.”

Source: U.S. Department of Health and Human Services