The combination of physical fitness as well as diet cannot be over emphasised.

Much of the focus on the mechanisms of benefit of exercise and fitness have focused on prevention of atherosclerosis and its complications, the specific effects of exercise on cardiac structure and function suggest that low fitness might be particularly important for long-term heart failure risk. Therefore, these authors looked at whether lower levels of fitness in healthy, middle-aged adults would be more strongly associated with heart failure hospitalization than with hospitalization for acute myocardial infarction.

Physical activity and cardiorespiratory fitness are important determinants of long-term cardiovascular disease mortality. Multiple studies have shown a strong and consistent association between a single measurement of fitness in midlife and risk of cardiovascular disease mortality decades later. However, limited data exist on the association between midlife fitness and nonfatal cardiovascular disease events, such as hospitalization for heart failure and myocardial infarction at a later age. The aim of this study was to determine the association between midlife physical fitness levels and the long-term risk for heart failure and acute myocardial infarction using data from Cooper Center Longitudinal Study participants linked to Medicare utilization data. The study found that low midlife fitness was associated with a significantly higher risk for heart failure hospitalization and acute myocardial infarction at a later age. Moreover, the magnitude of the association between low fitness and heart failure hospitalization was nearly twice that observed for the association between fitness and acute myocardial infarction. These findings highlight the importance of heart failure risk in the pathway from low fitness to cardiovascular disease mortality.

Physical Fitness and Risk for Heart Failure and Coronary Artery Disease
Jarett D. Berry, MD, MS, Ambarish Pandey, MD, Ang Gao, MS, David Leonard, PhD, Ramin Farzaneh-Far, MD, Colby Ayers, MS, Laura DeFina, MD and Benjamin Willis, MD, MPH
+ Author Affiliations

From the Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX (J.D.B., A.P., A.G., C.A.); Cooper Institute, Dallas, TX (D.L., L.D., B.W.); and Division of Cardiology, San Francisco General Hospital, University of California, San Francisco, CA.
Correspondence to Jarett D. Berry, MD, MS, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390–9047. E-mail jarett.berry@utsouthwestern.edu