Coronary risk factors and incidence of coronary death in relation to physical fitness. Seven-year follow-up study of middle-aged and elderly men

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Abstract
Physical fitness was assessed in relation to a near maximal bicycle exercise test in two populations; population 1: 122 middle aged and elderly cross-country skiers with a documented very high physical performance, and population 2: 2014 apparently healthy men 40–59 years of age. All were without known or suspected heart disease at the baseline study. A number of so-called coronary risk factors were studied simultaneously. The total incidence of coronary heart disease (CHD) events were noted as was the total 7 year incidence of death from CHD among men from population 2. By subdividing the latter in quartiles of physical fitness within each 5 year age group—and studying levels of coronary risk factors and CHD deaths within these 16 subgroups—the following findings were made: All coronary risk factors were favourably and strongly associated with high physical fitness and vice versa in consistent way. Death from myocardial infarction and sudden, unexpected death followed the same pattern in an inverse way. The skiers as a group closely followed the most fit men from population 2 in all respects. Thus we have noted a strong, graded, positive association between physical fitness and a number of coronary risk factors, and an inverse relationship between high physical fitness and the risk of dying from CHD. These findings hold true for a period of 7 years among middle aged men free fromknown orsuspected heart disease.