Does fitness improve the cardiovascular risk profile in obese subjects?

• Published in: Nutrition, metabolism, and cardiovascular diseases Vol. 27; no. 6; pp. 518 - 524
• Main Authors: Halland, H, Lønnebakken, M.T, Saeed, S, Midtbø, H, Cramariuc, D, Gerdts, E
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.06.2017
• Subjects: Adult; Aged; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Body Composition; Body Mass Index; Cardiorespiratory Fitness; Cardiovascular; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - physiopathology; Cardiovascular Diseases - prevention & control; Chi-Square Distribution; Cross-Sectional Studies; Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; Diabetes Mellitus - physiopathology; Diabetes Mellitus - prevention & control; Exercise Test; Female; Glucose Tolerance Test; Humans; Hypertension; Hypertension - diagnosis; Hypertension - epidemiology; Hypertension - physiopathology; Hypertension - prevention & control; Logistic Models; Male; Metabolic syndrome; Metabolic Syndrome - diagnosis; Metabolic Syndrome - epidemiology; Metabolic Syndrome - physiopathology; Metabolic Syndrome - prevention & control; Middle Aged; Multivariate Analysis; Norway - epidemiology; Obesity; Obesity - diagnosis; Obesity - epidemiology; Obesity - physiopathology; Odds Ratio; Predictive Value of Tests; Prevalence; Prognosis; Risk Assessment; Risk Factors; Smoking - adverse effects; Smoking Prevention; Time Factors; Waist Circumference; Hypertension; Obesity; Cardiorespiratory fitness; Metabolic syndrome
• ISSN: 0939-4753; 1590-3729
• DOI: 10.1016/j.numecd.2017.04.006

Abstract Background and aims Good cardiorespiratory fitness has been suggested to reduce the risk of cardiovascular disease in obesity. We explored the association of fitness with the prevalences of major cardiovascular risk factor like hypertension (HT), diabetes and metabolic syndrome (MetS) in overweight and obese subjects. Methods and results Clinical data from 491 participants in the FAT associated CardiOvasculaR dysfunction (FATCOR) study were analyzed. Physical fitness was assessed by ergospirometry, and subjects with at least good level of performance for age and sex were classified as fit. HT subtypes were identified from clinic and 24-h ambulatory blood pressure in combination. Diabetes was diagnosed by oral glucose tolerance test. MetS was defined by the American Heart Association and National Heart, Lung and Blood Institute criteria. The participants were on average 48 years old (60% women), and mean body mass index (BMI) was 32 kg/m2 . 28% of study participants were classified as fit. Fitness was not associated with lower prevalences of HT or HT subtypes, diabetes, MetS or individual MetS components (all p  > 0.05). In multivariable regression analysis, being fit was characterized by lower waist circumference, BMI < 30 kg/m2 , non-smoking and a higher muscle mass (all p  < 0.05). Conclusion In the FATCOR population, fitness was not associated with a lower prevalence of major cardiovascular risk factors like HT, diabetes or MetS. Given the strong association of cardiovascular risk factor burden with risk of clinical cardiovascular disease, these findings challenge the notion that fitness alone is associated with lower risk of cardiovascular disease in obesity.