Impact of Cardiorespiratory Fitness on Mortality in Black Male Veterans With Resistant Systemic Hypertension.
Title | Impact of Cardiorespiratory Fitness on Mortality in Black Male Veterans With Resistant Systemic Hypertension. |
Publication Type | Journal Article |
Year of Publication | 2017 |
Authors | Narayan, P., Doumas M., Kumar A., Faselis C. J., Myers J. N., Pittaras A., & Kokkinos P. F. |
Journal | Am J Cardiol |
Volume | 120 |
Issue | 9 |
Pagination | 1568-1571 |
Date Published | 2017 Nov 01 |
ISSN | 1879-1913 |
Keywords | African Americans, Aged, Cardiorespiratory Fitness, Cohort Studies, Exercise Tolerance, Humans, Hypertension, Male, Middle Aged, Proportional Hazards Models, Veterans |
Abstract | Patients with resistant systemic hypertension have poorer outcomes than nonresistant hypertensives. The purpose of this study was to evaluate the association between cardiorespiratory fitness and all-cause mortality in black male Veterans with resistant systemic hypertension. Patients were identified from a cohort undergoing exercise tolerance test at the department of Veterans Affairs Medical Center in Washington, DC. Patients were divided into 4 cardiorespiratory fitness categories based on age-specific peak metabolic equivalents achieved on a standard Bruce protocol. Multivariate Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality across all fitness categories. A total of 1,276 patients out of 9,068 hypertensives had resistant hypertension defined as systolic and/or diastolic blood pressure >140 and/or >90 mm Hg, respectively, on 3 antihypertensive medications, one of which was a diuretic or use of >4 antihypertensive medications. During a follow-up of 9.5 ± 4.2 years, an inverse association was observed between cardiorespiratory fitness and all-cause mortality in patients with resistant hypertension. Compared with the least-fit group, mortality was reduced by 21% in the low-fit group (HR 0.79, CI 0.60 to 1.05; p value: 0.280), 36% in the moderate-fit group (HR 0.64, CI 0.48 to 0.87; p value 0.001), and 62% in the high-fit group (HR 0.38, CI 0.25 to 0.56; p value <0.001). In conclusion, an inverse association was observed between the level of cardiorespiratory fitness and all-cause mortality in patients with resistant systemic hypertension. Compared with the least-fit referent group, the high-fit group had a significant 62% lower risk of all-cause mortality. |
DOI | 10.1016/j.amjcard.2017.07.055 |
Alternate Journal | Am. J. Cardiol. |
PubMed ID | 28886854 |
Grant List | IK6 RX002477 / RX / RRD VA / United States |