Cardiorespiratory fitness, muscular strength, and obesity in adolescence and later chronic disability due to cardiovascular disease: a cohort study of 1 million men
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AuthorHenriksson, Hanna; Henriksson, Pontus; Ruiz Ruiz, Jonatan; Ortega Porcel, Francisco Bartolomé
Oxford University Press
Cardiovascular diseaseCardiorespiratory fitnessMuscular strengthObesityDisability
Hanna Henriksson, Pontus Henriksson, Per Tynelius, Mattias Ekstedt, Daniel Berglind, Idoia Labayen, Jonatan R Ruiz, Carl J Lavie, Francisco B Ortega, Cardiorespiratory fitness, muscular strength, and obesity in adolescence and later chronic disability due to cardiovascular disease: a cohort study of 1 million men, European Heart Journal, Volume 41, Issue 15, 14 April 2020, Pages 1503–1510, [https://doi.org/10.1093/eurheartj/ehz774]
SponsorshipKarolinska Institutet 201802043; Swedish Society of Medicine; County Council of Ostergotland, Sweden; Henning and Johan Throne-Holst Foundation; Strategic Research Area Health Care Science, Karolinska Institutet/Umea University; European Union (EU) 667 302; University of Granada Plan Propio de Investigación 2016-Excellence actions: Unit of Excellence on Exercise and Health (UCEES); Junta de Andalucía, Consejeria de Conocimiento, Investigacion y Universidades European Regional Development Fund (ERDF) SOMM17/6107/UGR; SAMID III network, RETICS - PN IthornDthornI 2017-2021 (Spain), ISCIII-Sub-Directorate General for Research Assessment and Promotion (ERDF) RD16/0022; EXERNET Research Network on Exercise and Health in Special Populations DEP200500046/ACTI
Aims Cardiorespiratory fitness, muscular strength, and obesity in adulthood are risk factors for cardiovascular disease (CVD). However, little is known regarding the associations of these risk factors, already in adolescence, with later disability due to chronic CVD. Hence, we investigated associations of cardiorespiratory fitness, muscular strength, and body mass index (BMI) in adolescence with later chronic disability due to specific causes of CVD disability (i.e. cerebrovascular disease, ischaemic heart disease and heart failure). Methods and results This population-based cohort study included 1 078 685 male adolescents (16–19 years) from the Swedish military conscription register from 1972 to 1994. Cardiorespiratory fitness (bicycle ergometer test), muscular strength (knee extension strength), and BMI were measured during the conscription examination. Information about disability pension due to CVD was retrieved from the Social Insurance Agency during a mean follow-up of 28.4 years. Cardiorespiratory fitness was strongly and inversely associated with later risk of chronic CVD disability for all investigated causes. The association was particularly strong for ischaemic heart diseases (hazard ratio 0.11, 95% confidence interval 0.05–0.29 for highest vs. lowest fitness-quintiles). Furthermore, overweight/obesity were associated with CVD disability for all investigated causes. Conversely, associations of muscular strength with CVD disability were generally weak. Conclusions This study provides evidence for associations between low levels of cardiorespiratory fitness and obesity with later risk of chronic disability due to CVD. Preventive actions may begin at young ages and include promotion of cardiorespiratory fitness and healthy body weight.