Puffed out? Not exercising is as deadly as smoking

And the fitter you get, the lower your risk of dying, study shows

Poor cardiovascular fitness is up there with smoking and diabetes when it comes to an increased risk of dying, say researchers, who have found fitness is inversely proportional to the risk of death.

The study assesses all-cause mortality, based on exercise treadmill testing, in more than 122,000 patients (average age of 53), with the participants divided into five performance levels: elite, high, above average, below average and low.

Those with the lowest aerobic fitness were found to be five times more likely to die over the eight-year follow-up period than the elite performers.

Furthermore, poor fitness had a similar impact on the risk of death as smoking, diabetes and coronary artery disease.

And those with hypertension had a 30% lower risk of death if they gained an elite level of fitness compared with those of a high fitness level, according to the US research published in the Journal of the American Medical Association.

More than 13,000 of the study participants died during the eight-year follow-up period.

While previous studies have found adverse cardiovascular outcomes with vigorous exercise, the study authors report no upper limits to the benefits of fitness.

“Cardiovascular fitness is a modifiable indicator of long-term mortality, and health professionals should encourage patients to achieve and maintain high levels of fitness,” they say.

“Extremely high aerobic fitness was associated with the greatest survival and was associated with benefit in older patients and those with hypertension.”

In addition to the reduced mortality risk, comorbidities decrease with increasing fitness, with the exception of hyperlipidaemia.

"Aerobic fitness is something that most patients can control. And we found in our study there is no limit to how much exercise is too much," says senior author and cardiologist Dr Wael Jaber, from the Cleveland Clinic Foundation in Ohio, US.

"Everyone should be encouraged to achieve and maintain high fitness levels."

More information: JAMA Open Network, 19 October 2018