RT Journal Article
SR Electronic
T1 Midlife cardiorespiratory fitness and the long-term risk of chronic obstructive pulmonary disease
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 843
OP 848
DO 10.1136/thoraxjnl-2018-212821
VO 74
IS 9
A1 Hansen, Gorm Mørk
A1 Marott, Jacob Louis
A1 Holtermann, Andreas
A1 Gyntelberg, Finn
A1 Lange, Peter
A1 Jensen, Magnus T
YR 2019
UL http://thorax.bmj.com/content/74/9/843.abstract
AB Background Good midlife cardiorespiratory fitness (CRF) may reduce the risk of chronic obstructive pulmonary disease (COPD). Reverse causation may play a role if follow-up time is short. We examined the association between CRF and both incident COPD and COPD mortality in employed men with up to 46 years follow-up, which allowed us to account for reverse causality.Methods Middle-aged men (n=4730) were recruited in 1970–1971. CRF was determined as VO2max by ergometer test. Categories of CRF (low, normal, high) were defined as ± 1 Z-score (± 1 SD) above or below the age-adjusted mean. Endpoints were identified through national registers and defined as incident COPD, and death from COPD. Multi-adjusted Cox models and restricted mean survival times (RMST) were performed.Results Compared with low CRF, the estimated risk of incident COPD was 21% lower in participants with normal CRF (HR 0.79, 95% CI 0.63 to 0.99) and 31 % lower with high CRF (HR 0.69, 95% CI 0.52 to 0.91). Compared with low CRF, the risk of death from COPD was 35% lower in participants with normal CRF (HR 0.65, 95% CI 0.46 to 0.91) and 62% lower in participants with high CRF (HR 0.38, 95% CI 0.23 to 0.61). RMST showed a delay to incident COPD and death from COPD in the magnitude of 1.3–1.8 years in normal and high CRF vs low CRF. Test for reverse causation did not alter the results.Conclusion In a population of healthy, middle-aged men, higher levels of CRF were associated with a lower long-term risk of incident COPD and death from COPD.