Midlife cardiorespiratory fitness and the long-term risk of chronic obstructive pulmonary disease

Gorm Mørk Hansen*, Jacob Louis Marott, Andreas Holtermann, Finn Gyntelberg, Peter Lange, Magnus T. Jensen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

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.

Original languageEnglish
JournalThorax
Volume74
Issue number9
Pages (from-to)843-848
ISSN0040-6376
DOIs
Publication statusPublished - Sep 2019

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Chronic Obstructive Pulmonary Disease
Causality
Cardiorespiratory Fitness
Survival Rate
Proportional Hazards Models

Keywords

  • copd epidemiology
  • exercise

Cite this

Hansen, G. M., Marott, J. L., Holtermann, A., Gyntelberg, F., Lange, P., & Jensen, M. T. (2019). Midlife cardiorespiratory fitness and the long-term risk of chronic obstructive pulmonary disease. Thorax, 74(9), 843-848. https://doi.org/10.1136/thoraxjnl-2018-212821
Hansen, Gorm Mørk ; Marott, Jacob Louis ; Holtermann, Andreas ; Gyntelberg, Finn ; Lange, Peter ; Jensen, Magnus T. / Midlife cardiorespiratory fitness and the long-term risk of chronic obstructive pulmonary disease. In: Thorax. 2019 ; Vol. 74, No. 9. pp. 843-848.
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title = "Midlife cardiorespiratory fitness and the long-term risk of chronic obstructive pulmonary disease",
abstract = "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.",
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Hansen, GM, Marott, JL, Holtermann, A, Gyntelberg, F, Lange, P & Jensen, MT 2019, 'Midlife cardiorespiratory fitness and the long-term risk of chronic obstructive pulmonary disease', Thorax, vol. 74, no. 9, pp. 843-848. https://doi.org/10.1136/thoraxjnl-2018-212821

Midlife cardiorespiratory fitness and the long-term risk of chronic obstructive pulmonary disease. / Hansen, Gorm Mørk; Marott, Jacob Louis; Holtermann, Andreas; Gyntelberg, Finn; Lange, Peter; Jensen, Magnus T.

In: Thorax, Vol. 74, No. 9, 09.2019, p. 843-848.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Midlife cardiorespiratory fitness and the long-term risk of chronic obstructive pulmonary disease

AU - Hansen, Gorm Mørk

AU - Marott, Jacob Louis

AU - Holtermann, Andreas

AU - Gyntelberg, Finn

AU - Lange, Peter

AU - Jensen, Magnus T.

PY - 2019/9

Y1 - 2019/9

N2 - 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.

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.

KW - copd epidemiology

KW - exercise

U2 - 10.1136/thoraxjnl-2018-212821

DO - 10.1136/thoraxjnl-2018-212821

M3 - Journal article

VL - 74

SP - 843

EP - 848

JO - Thorax

JF - Thorax

SN - 0040-6376

IS - 9

ER -