Background: The study investigated the association between self-reported physical fitness (SRPF) and mortality in 3,248 participants of the Ludwigshafen Risk and Cardiovascular Health (LURIC) study with a mean follow-up of 9.9 (range 0.1-11.9) years (30.0%, women).
Methods: Kaplan-Meier survival analysis and Cox regression models, demonstrate that participants with higher SRPF had a significantly lower risk of all-cause and cardiovascular mortality.
Results: Even after adjustment for age, gender, hypertension, diabetes mellitus, low density lipoprotein cholesterol LDL-C, glycated haemoglobin A1c (HbA1c), smoking, and other confounders, these associations remained robust and statistically significant (p<0.001). Participants in the highest SRPF class had the lowest risk for cardiovascular mortality at a hazard ratio [HR (95% CI)] of 0.14 (0.08-0.24) compared to the lowest class (p<0.001). Similar results were seen in both, participants with angiographically documented coronary artery disease (CAD, n=2583, 78%) and those without CAD (n=733; 22%). Investigation of the involved biomedical processes suggested that higher physical fitness was associated with significantly lower systolic blood pressure and heart rate (both p<0.001) as well as substantially lower HbA1c (p<0.001), fasting glucose concentrations (p<0.001), serum uric acid concentrations (p<0.001) and inflammatory markers such as hs-CRP, IL-6, and SAA (all p<0.001). Conversely, Apolipoprotein A-2 and HDL-cholesterol concentrations increased with higher physical fitness levels (p<0.001).
Conclusion: Our findings suggest that self-reported physical fitness is a powerful and independent marker of all-cause and cardiovascular mortality in individuals with and without CAD. Based on these results, the self-assessment of physical fitness should be included in routine medical check-ups. Our findings add to the growing body of evidence that physical fitness confers protective effects, highlighting the importance of physical activity promotion for cardiovascular health.
