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Active Voice: Does Cardiorespiratory Fitness Level Trump LDL-Cholesterol Level for Predicting CHD Mortality?

from By Steve Farrell, Ph.D.

Viewpoints presented in SMB commentaries reflect opinions of the authors and do not necessarily reflect positions or policies of ACSM.

Dr. Farrell is the science officer for the Division of Education at The Cooper Institute in Dallas. He and his colleagues have delivered health and fitness workshops around the globe for the past 30 years. His main area of research focuses on the associations among cardiorespiratory fitness, adiposity, and various health outcomes. This commentary presents Dr. Farrell’s views associated with the research article he and his colleagues published in the November issue of ACSM’s Medicine and Science in Sports and Exercise® (MSSE).

There is broad consensus that elevated levels of LDL cholesterol and low levels of cardiorespiratory fitness (CRF) are powerful independent risk factors for coronary heart disease (CHD). Is it possible that one might be a stronger predictor of CHD mortality than the other? My colleagues and I designed a study that would look at all possible combinations of CRF and LDL and the subsequent risk of CHD mortality. In this study, recently reported in MSSE, we followed 40,718 apparently healthy men who underwent a comprehensive baseline physical exam at the Cooper Clinic during 1978-2006. All men had a maximal treadmill stress test and blood work at the time of their exam. We divided the group into three categories of CRF:

Low fit: the bottom 20% (1st quintile) compared to other men in their age group.
Moderate fit: the next 40% (2nd and 3rd quintile) compared to other men in their age group.
High fit: the top 40% (4th and 5th quintile) compared to other men in their age group. more


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