The Association between Physical Fitness and Diagnosed Chronic Disease in Health Maintenance Organization Members

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Abstract
Purpose.: The purpose of this investigation was to determine the relationship between predicted cardiorespiratory fitness (predicted VO2max) and diagnosed chronic disease. Design.: A stratified random sample of individuals was surveyed. Setting.: Large Health Maintenance Organization (HMO) in the upper Midwest. Subjects.: HMO members (N = 8000), age 40 and over, with none, one, or two or more of the following diagnosed chronic conditions: hypertension, diabetes, dyslipidemia, and heart disease. Measures.: Predicted VO2max was estimated for those respondents who completed the survey providing all critical data elements (n = 4121; representing 51.5% of total sample). Predicted VO2max was compared across chronic conditions using analysis of variance. The proportion of subjects across fitness quintiles by number of chronic conditions was tested using the χ2 test. Results.: Subjects without chronic conditions showed higher predicted VO2max values (29.8 ± 7.7 ml/kg/min) than those with one (25.9 ± 7.8 ml/kg/min) or two or more conditions (25.7 ±7.9 ml/kg/min) (p < .0001). Subjects with diabetes, hypertension, and heart disease reported lower predicted VO2max than their healthier counterparts (p < .0001), but this was not the case for dyslipidemia subjects (27.6 ± 7.6 vs. 27.4 ± 8.2 ml/kg/min, respectively; p < .58). A larger proportion of diseased subjects was in the lowest fitness quintile for diabetes, hypertension, and heart disease, but not for dyslipidemia. Conclusions.: As a group, chronic disease patients appear to have lower levels of physical fitness than subjects without chronic disease. Physical fitness improvement in diseased populations should be supported in the clinical setting.