Cardiorespiratory fitness and mortality from all causes, cardiovascular disease and cancer: dose-response meta-analysis of cohort studies.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of prospective cohort studies
PubMed 35022163 · doi:10.1136/bjsports-2021-104876
What was done
A systematic review and dose-response meta-analysis was conducted across PubMed, EMBASE, and Web of Science (searched up to December 26, 2019) to evaluate the association between cardiorespiratory fitness (CRF) and mortality in healthy populations. Cohort studies were included if CRF was objectively assessed by an exercise stress test and reported as at least three categories or per incremental increase. Generalized least-squares regression models were used to assess the quantitative dose-response relations with all-cause, cardiovascular disease (CVD), and cancer mortality.
What was found
Thirty-four cohort studies were included. Per 1-metabolic equivalent (MET) increase in CRF, pooled relative risks (RRs) were: - All-cause mortality: 0.88 (95% CI 0.83 to 0.93) - CVD mortality: 0.87 (95% CI 0.83 to 0.91) - Cancer mortality: 0.93 (95% CI 0.91 to 0.96) Comparing categories to the lowest CRF: - Intermediate CRF: all-cause RR 0.67 (95% CI 0.61 to 0.74); CVD RR 0.60 (95% CI 0.51 to 0.69); cancer RR 0.76 (95% CI 0.69 to 0.84). - Highest CRF: all-cause RR 0.47 (95% CI 0.39 to 0.56); CVD RR 0.49 (95% CI 0.42 to 0.56); cancer RR 0.57 (95% CI 0.46 to 0.70).
Why it matters
This study provides quantitative evidence of a clear, inverse dose-response relationship between objective cardiorespiratory fitness and risk of dying from CVD, cancer, and all causes in healthy populations.
Limits
The review synthesizes observational cohort studies, meaning causality cannot be firmly established and residual confounding remains possible. The total number of individual participants is not provided in the abstract, and the search concluded in late 2019.
Cited by
- supports Cardiorespiratory/exercise capacity is a predictor of mortality and is important for maintaining cardiovascular health and function.