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Elevated resting heart rate, physical fitness and all-cause mortality: a 16-year follow-up in the Copenhagen Male Study.

https://arctichealth.org/en/permalink/ahliterature114654
Source
Heart. 2013 Jun;99(12):882-7
Publication Type
Article
Date
Jun-2013
Author
Magnus Thorsten Jensen
Poul Suadicani
Hans Ole Hein
Finn Gyntelberg
Author Affiliation
Department of Cardiology, Copenhagen University Hospital Gentofte, Niels Andersens Vej 65, 2900 Hellerup, Denmark. magnustjensen@gmail.com
Source
Heart. 2013 Jun;99(12):882-7
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Aged
Cardiovascular Diseases - mortality - physiopathology
Cause of Death - trends
Denmark - epidemiology
Electrocardiography - methods
Follow-Up Studies
Heart Rate - physiology
Humans
Male
Middle Aged
Motor Activity - physiology
Physical Fitness - physiology
Prognosis
Proportional Hazards Models
Prospective Studies
Rest - physiology
Risk factors
Time Factors
Abstract
To examine whether elevated resting heart rate (RHR) is an independent risk factor for mortality or a mere marker of physical fitness (VO2Max).
This was a prospective cohort study: the Copenhagen Male Study, a longitudinal study of healthy middle-aged employed men. Subjects with sinus rhythm and without known cardiovascular disease or diabetes were included. RHR was assessed from a resting ECG at study visit in 1985-1986. VO2Max was determined by the Ã?strand bicycle ergometer test in 1970-1971. Subjects were classified into categories according to level of RHR. Associations with mortality were studied in multivariate Cox models adjusted for physical fitness, leisure-time physical activity and conventional cardiovascular risk factors.
2798 subjects were followed for 16 years. 1082 deaths occurred. RHR was inversely related to physical fitness (p 90 had an HR (95% CI) of 3.06 (1.97 to 4.75). With RHR as a continuous variable, risk of mortality increased with 16% (10-22) per 10 beats per minute (bpm). There was a borderline interaction with smoking (p = 0.07); risk per 10 bpm increase in RHR was 20% (12-27) in smokers, and 14% (4-24) in non-smokers.
Elevated RHR is a risk factor for mortality independent of physical fitness, leisure-time physical activity and other major cardiovascular risk factors.
Notes
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PubMed ID
23595657 View in PubMed
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Long work hours and physical fitness: 30-year risk of ischaemic heart disease and all-cause mortality among middle-aged Caucasian men.

https://arctichealth.org/en/permalink/ahliterature141012
Source
Heart. 2010 Oct;96(20):1638-44
Publication Type
Article
Date
Oct-2010
Author
Andreas Holtermann
Ole Steen Mortensen
Hermann Burr
Karen Søgaard
Finn Gyntelberg
Poul Suadicani
Author Affiliation
National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen Ø 2100, Denmark. aho@nrcwe.dk
Source
Heart. 2010 Oct;96(20):1638-44
Date
Oct-2010
Language
English
Publication Type
Article
Keywords
Adult
Denmark - epidemiology
European Continental Ancestry Group
Exercise Test - methods
Follow-Up Studies
Humans
Life Style
Male
Middle Aged
Myocardial Ischemia - etiology - mortality - physiopathology
Occupational Diseases - etiology - mortality - physiopathology
Oxygen Consumption - physiology
Physical Fitness - physiology
Risk Assessment - methods
Work Schedule Tolerance - physiology
Workload - statistics & numerical data
Abstract
No previous long-term studies have examined if workers with low physical fitness have an increased risk of cardiovascular mortality due to long work hours. The aim of this study was to test this hypothesis.
The study comprised 30-year follow-up of a cohort of 5249 gainfully employed men aged 40-59years in the Copenhagen Male Study. 274 men with cardiovascular disease were excluded from the follow-up. Physical fitness (maximal oxygen consumption, Vo(2)max) was estimated using the Åstrand bicycle ergometer test, and number of work hours was obtained from questionnaire items; 4943 men were eligible for the incidence study.
587 men (11.9%) died because of ischaemic heart disease (IHD). Cox analyses adjusted for age, blood pressure, smoking, alcohol, body mass index, diabetes, hypertension, physical work demands, and social class, showed that working more than 45h/week was associated with an increased risk of IHD mortality in the least fit (Vo(2)max range 15-26; HR 2.28, 95% CI 1.10 to 4.73), but not intermediate (Vo(2)max range 27-38; HR 0.94, 95% CI 0.59 to 1.51) and most fit men (Vo(2)max range 39-78; HR 0.91, 95% CI 0.41 to 2.02) referencing men working less than 40h/week.
The findings indicate that men with low physical fitness are at increased risk for IHD mortality from working long hours. Men working long hours should be physically fit.
PubMed ID
20820054 View in PubMed
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Physical demands at work, physical fitness, and 30-year ischaemic heart disease and all-cause mortality in the Copenhagen Male Study.

https://arctichealth.org/en/permalink/ahliterature144584
Source
Scand J Work Environ Health. 2010 Sep;36(5):357-65
Publication Type
Article
Date
Sep-2010
Author
Andreas Holtermann
Ole Steen Mortensen
Hermann Burr
Karen Søgaard
Finn Gyntelberg
Poul Suadicani
Author Affiliation
National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark. aho@nrcwe.dk
Source
Scand J Work Environ Health. 2010 Sep;36(5):357-65
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Adult
Bicycling - physiology
Confidence Intervals
Denmark - epidemiology
Heart rate
Humans
Life Style
Male
Middle Aged
Mortality - trends
Motor Activity - physiology
Multivariate Analysis
Myocardial Ischemia - epidemiology - mortality
Occupational Health
Oxygen consumption
Physical Fitness - physiology
Proportional Hazards Models
Prospective Studies
Questionnaires
Regression Analysis
Risk assessment
Time Factors
Workload
Abstract
No previous long-term prospective studies have examined if workers with low cardiorespiratory fitness have an increased risk of cardiovascular mortality due to high physical work demands. We tested this hypothesis.
We carried out a 30-year follow-up of the Copenhagen Male Study of 5249 employed men aged 40-59 years. We excluded from follow-up 274 men with a history of myocardial infarction, prevalent symptoms of angina pectoris, or intermittent claudication. We estimated physical fitness [maximal oxygen consumption (VO (2)Max)] using the Astrand cycling test and determined physical work demands with two self-reported questions.
In the Copenhagen Male Study, 587 men (11.9%) died due to ischaemic heart disease (IHD). Using men with low physical work demands as the reference group, Cox analyses--adjusted for age, blood pressure, smoking, alcohol consumption, body mass index, diabetes, and hypertension--showed that high physical work demands were associated with an increased risk of IHD mortality in the least fit [VO (2)Max range 15-26, N=892, hazard ratio (HR) 2.04, 95% confidence interval (95% CI) 1.20-3.49] and moderately fit (VO (2)Max range 27-38, N=3037, HR 1.75, 95% CI 1.24-2.46), but not among the most fit men (VO (2)Max range 39-78, N=1014, HR 1.08, 95% CI 0.52-2.17). We found a similar, although slightly weaker, relationship with respect to all-cause mortality.
The hypothesis was supported. Men with low and medium physical fitness have an increased risk of cardiovascular and all-cause mortality if exposed to high physical work demands. Ours observations suggest that, among men with high physical work demands, being physically fit protects against adverse cardiovascular effects.
Notes
Comment In: Scand J Work Environ Health. 2010 Sep;36(5):349-5520686737
PubMed ID
20352174 View in PubMed
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Physical work demands and physical fitness in low social classes--30-year ischemic heart disease and all-cause mortality in the Copenhagen Male Study.

https://arctichealth.org/en/permalink/ahliterature130300
Source
J Occup Environ Med. 2011 Nov;53(11):1221-7
Publication Type
Article
Date
Nov-2011
Author
Andreas Holtermann
Ole Steen Mortensen
Hermann Burr
Karen Søgaard
Finn Gyntelberg
Poul Suadicani
Author Affiliation
The Copenhagen Male Study, Epidemiological Research Unit, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark. aho@nrcwe.dk
Source
J Occup Environ Med. 2011 Nov;53(11):1221-7
Date
Nov-2011
Language
English
Publication Type
Article
Keywords
Adult
Denmark - epidemiology
Employment
Exercise Test
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Ischemia - mortality
Physical Exertion - physiology
Physical Fitness - physiology
Poverty
Proportional Hazards Models
Questionnaires
Risk
Abstract
Investigate whether high physical work demands increase risk of ischemic heart disease (IHD) mortality among men of low social class with low physical fitness.
Thirty-year follow-up in the Copenhagen Male Study of 5249 men aged 40 to 59 years without cardiovascular disease. Physical fitness was estimated using the Åstrand cycling test, and physical work demands determined by two self-reported questions.
Among 2707 low social class men, multiple-adjusted Cox proportional hazard ratios showed an almost threefold increased risk of IHD mortality among men with high physical work demands and low physical fitness, but not among men with a high physical fitness, referencing men with low physical work demands.
These findings among low social class men support that high physical work demands increases the risk of IHD mortality among those with low physical fitness.
PubMed ID
22015549 View in PubMed
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Self-reported cardiorespiratory fitness: prediction and classification of risk of cardiovascular disease mortality and longevity--a prospective investigation in the Copenhagen City Heart Study.

https://arctichealth.org/en/permalink/ahliterature272092
Source
J Am Heart Assoc. 2015 Jan;4(1):e001495
Publication Type
Article
Date
Jan-2015
Author
Andreas Holtermann
Jacob Louis Marott
Finn Gyntelberg
Karen Søgaard
Ole Steen Mortensen
Eva Prescott
Peter Schnohr
Source
J Am Heart Assoc. 2015 Jan;4(1):e001495
Date
Jan-2015
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Cardiovascular Diseases - diagnosis - mortality - therapy
Cause of Death
Cohort Studies
Denmark
Female
Humans
Longevity
Male
Middle Aged
Physical Fitness - physiology
Predictive value of tests
Prospective Studies
Self Report
Sex Factors
Urban Population
Abstract
The predictive value and improved risk classification of self-reported cardiorespiratory fitness (SRCF), when added to traditional risk factors on cardiovascular disease (CVD) and longevity, are unknown.
A total of 3843 males and 5093 females from the Copenhagen City Heart Study without CVD in 1991-1994 were analyzed using multivariate Cox hazards regression to assess the predictive value and survival benefit for CVD and all-cause mortality from SRCF. The category-free net reclassification improvement from SRCF was calculated at 15-year follow-up on CVD and all-cause mortality. Overall, 1693 individuals died from CVD. In the fully adjusted Cox model, those reporting the same (hazard ratio [HR], 1.17; 95% confidence interval [CI], 1.04 to 1.32) and lower (HR, 1.91; 95% CI, 1.62 to 2.24) SRCF than peers had an increased risk of CVD mortality, compared with individuals with higher SRCF. Compared with individuals with higher SRCF, those with the same and lower SRCF had 1.8 (95% CI, 1.0 to 2.5) and 5.1 (95% CI, 4.1 to 6.2) years lower life expectancy, respectively. Individuals with lower SRCF had a significantly increased risk of CVD mortality, compared with individuals with higher SRCF, within each strata of leisure time physical activity and self-rated health, and SRCF significantly predicted CVD mortality independently of self-rated health and walking pace. A net reclassification improvement of 30.5% (95% CI, 22.1% to 38.9%) for CVD mortality was found when adding SRCF to traditional risk factors. Comparable findings were found for all-cause mortality.
SRCF has independent predictive value, is related to a considerable survival benefit, and improves risk classification when added to traditional risk factors of CVD and all-cause mortality. SRCF might prove useful in improved risk stratification in primary prevention.
Notes
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PubMed ID
25628408 View in PubMed
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