Occupational Physical Activity and Fitness in Predicting Cardiovascular Mortality among European Cohorts of Middle-Aged Men: A 60-Year Follow-Up in the Seven Countries Study

Author:

Puddu Paolo Emilio12ORCID,Kafatos Anthony3,Tolonen Hanna4ORCID,Geleijnse Johanna M.5ORCID,Menotti Alessandro1ORCID

Affiliation:

1. Association for Cardiac Research, 00182 Rome, Italy

2. EA 4650, Signalisation, Électrophysiologie et Imagerie des Lésions d’Ischémie Reperfusion Myocardique, Université de Normandie, 14000 Caen, Normandie, France

3. Department of Social Medicine, Preventive Medicine and Nutrition Clinic, University of Crete, 70013 Heraklion, Crete, Greece

4. Finnish Institute for Health and Welfare, 00271 Helsinki, Finland

5. Division of Human Nutrition and Health, Wageningen University, 6708 PB Wageningen, The Netherlands

Abstract

Aim and Background: To determine whether occupational physical activity (OPA) and physical fitness (Fitscore) predict cardiovascular disease (CVD) mortality and its components. Methods: Among middle-aged men (N = 5482) of seven cohorts of the Seven Countries Study (SCS), several baseline risk factors were measured, and there was a follow-up for 60 years until virtual extinction. OPA was estimated from the type of work while Fitscore was derived from linear combinations of levels of arm circumference, heart rate and vital capacity computed as a factor score by principal component analysis. The predictive adjusted power of these characteristics was obtained by Cox models for coronary heart disease (CHD), heart diseases of uncertain etiology (HDUE), stroke and CVD outcomes. Results: Single levels of the three indicators of fitness were highly related to the three levels of OPA and Fitscore. High levels of both OPA and Fitscore forced into the same models were associated with lower CVD, CHD, HDUE and stroke mortality. When assessed concomitantly in the same models, hazard ratios (high versus low) for 60-year CVD mortality were 0.88 (OPA: 95% CI: 0.78–0.99) and 0.68 (Fitscore 95% CI: 0.61–0.75), and the predictive power of Fitscore outperformed that of OPA for CHD, HDUE and stroke outcomes. Similar results were obtained in individual outcome models in the presence of risk factors. Segregating the first 30 from the second 30 years of follow-up indicated that people dying earlier had lower arm circumference and vital capacity, whereas heart rate was higher for CVD and most of its major components (all p < 0.0001). Conclusions: OPA was well related to the indicators of fitness involving muscular mass, cardio-circulatory and respiratory functions, thus adding predictive power for CVD events. The Fitscore derived from the above indicators represents another powerful long-term predictor of CHD, HDUE and stroke mortality.

Funder

National Heart Institute

American Heart Association

Finnish Heart Association

Finnish State Science Board

Sigrid Juselius Fund

Yrjö Jahnsson Foundation

Netherlands Prevention Foundation

National Institute of Public Health and the Environment

Royal Netherlands Academy of Arts and Sciences

Ministry of Public Health

Nutrition Council

Organisation for Food and Nutrition Research

Netherlands Heart Foundation

Netherlands Cancer Foundation

Association for Cardiac Research, Rome

Centre of Cardiovascular Disease, S. Camillo Hospital

National Institute of Public Health

National Research Council

European Union

Centre for the fight against infarction, Rome

Royal Institute for Research

Elais Oil Company

Publisher

MDPI AG

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