Tagged Blood Pressure

Being Unfit May Be Almost as Bad for You as Smoking

Photo

Credit Getty Images

Being out of shape could be more harmful to health and longevity than most people expect, according to a new, long-term study of middle-aged men. The study finds that poor physical fitness may be second only to smoking as a risk factor for premature death.

It is not news that aerobic capacity can influence lifespan. Many past epidemiological studies have found that people with low physical fitness tend to be at high risk of premature death. Conversely, people with robust aerobic capacity are likely to have long lives.

But most of those studies followed people for about 10 to 20 years, which is a lengthy period of time for science but nowhere near most of our actual lifespans. Some of those studies also enrolled people who already were elderly or infirm, making it difficult to extrapolate the findings to younger, healthier people.

So for the new study, which was published this week in the European Journal of Preventive Cardiology, researchers from the University of Gothenburg in Sweden and other institutions turned to an impressively large and long-term database of information about Swedish men.

The data set, prosaically named the Study of Men Born in 1913, involved exactly that. In 1963, almost 1,000 healthy 50-year-old men in Gothenburg who had been born in 1913 agreed to be studied for the rest of their lives, in order to help scientists better understand lifetime risks for disease, especially heart disease.

The men completed baseline health testing in 1963, including measures of their blood pressure, weight and cholesterol, and whether they exercised and smoked. Four years later, when the volunteers were 54, some underwent more extensive testing, including an exercise stress test designed to precisely determine their maximum aerobic capacity, or VO2 max. Using the results, the scientists developed a mathematical formula that allowed them to estimate the aerobic capacity of the rest of the participants.

Aerobic capacity is an interesting measure for scientists to study, because it is affected by both genetics and lifestyle. Some portion of our VO2 max is innate; we inherit it from our parents. But much of our endurance capacity is determined by our lifestyle. Being sedentary lowers VO2 max, as does being overweight. Exercise raises it.

Among this group of middle-aged men, aerobic capacities ranged from slight to impressively high, and generally reflected the men’s self-reported exercise habits. Men who said that they seldom worked out tended to have a low VO2 max. (Because VO2 max is more objective than self-reports about exercise, the researchers focused on it.)

To determine what impact fitness might have on lifespan, the scientists grouped the men into three categories: those with low, medium or high aerobic capacity at age 54.

Then they followed the men for almost 50 years. During that time, the surviving volunteers completed follow-up health testing about once each decade. The scientists also tracked deaths among the men, based on a national registry.

Then they compared the risk of relatively early death to a variety of health parameters, particularly each man’s VO2 max, blood pressure, cholesterol profile and history of smoking. (They did not include body weight as a separate measure, because it was indirectly reflected by VO2 max.)

Not surprisingly, smoking had the greatest impact on lifespan. It substantially shortened lives.

But low aerobic capacity wasn’t far behind. The men in the group with the lowest VO2 max had a 21 percent higher risk of dying prematurely than those with middling aerobic capacity, and about a 42 percent higher risk of early death than the men who were the most fit.

Poor fitness turned out to be unhealthier even than high blood pressure or poor cholesterol profiles, the researchers found. Highly fit men with elevated blood pressure or relatively unhealthy cholesterol profiles tended to live longer than out-of-shape men with good blood pressure and cholesterol levels.

Of course, this study found links between poor fitness and shortened lifespans. It cannot prove that one caused the other, or explain how VO2 max might affect lifespan. However, the findings raise the possibility, as the scientists speculate, that by strengthening the body, better fitness may lower the risk of a variety of chronic diseases.

This study also involved men — and Swedish men at that. So whether the findings are applicable to other people, particularly women, is uncertain.

But “there is no reason not to think” that the rest of us would also share any beneficial associations between fitness and longevity, said Per Ladenvall, a researcher at the Sahlgrenska Academy at the University of Gothenburg, who led the study. Past studies involving women have found such links, he said.

Encouragingly, if you now are concerned about the state of your particular aerobic capacity, you most likely can increase it just by getting up and moving. “Even small amounts of physical activity,” Dr. Ladenvall said, “may have positive effects on fitness.”

Ask Well: Is Watermelon Good for You?

Photo

Credit Karsten Moran for The New York Times

Do you have a health question? Submit your question to Ask Well.

Related:

For more fitness, food and wellness news, follow us on Facebook and Twitter, or sign up for our newsletter.

A Low-Salt Diet May Be Bad for the Heart

Photo

Credit Tony Cenicola/The New York Times

People with high blood pressure are often told to eat a low-sodium diet. But a diet that’s too low in sodium may actually increase the risk for cardiovascular disease, a review of studies has found.

Current guidelines recommend a daily maximum of 2.3 grams of sodium a day — the amount found in a teaspoon of salt — for most people, and less for the elderly or people with hypertension.

Researchers reviewed four observational studies that included 133,118 people who were followed for an average of four years. The scientists took blood pressure readings, and estimated sodium consumption by urinalysis. The review is in Lancet.

Among 69,559 people without hypertension, consuming more than seven grams of sodium daily did not increase the risk for disease or death, but those who ate less than three grams had a 26 percent increased risk for death or for cardiovascular events like heart disease and stroke, compared with those who consumed four to five grams a day.

In people with high blood pressure, consuming more than seven grams a day increased the risk by 23 percent, but consuming less than three grams increased the risk by 34 percent, compared with those who ate four to five grams a day.

The lead author, Andrew Mente, an epidemiologist at McMaster University in Toronto, said that eating less salt does indeed lower blood pressure.

“But low sodium intake may be harmful,” he added. “It’s important not to rely on blood pressure alone, but rather to look at actual clinical events — heart attack, stroke, mortality.”

Potatoes Tied to High Blood Pressure Risk

Photo

Credit Karsten Moran for The New York Times

Eating potatoes four or more times a week may increase the risk for high blood pressure, a large new study has found.

Researchers pooled results from three observational studies involving 187,453 men and women followed for more than 25 years. The participants returned health and diet questionnaires every two years, including whether a doctor had diagnosed hypertension. The study is in BMJ.

After controlling for body mass index, physical activity, smoking and other factors, they found that compared to eating potatoes only once a month, having one potato — baked, boiled or mashed — four to six times a week increased the risk for hypertension by 11 percent. Eating four or more four-ounce servings of French fries a week increased the risk by 17 percent. Adjusting for salt and saturated fat intake did not change the results, but the authors acknowledge that they could not control for all possible variables.

The researchers suggest that potatoes cause a rapid rise in blood glucose levels, which is associated with blood vessel problems and inflammation. This may increase the risk for hypertension.

“We don’t completely know what a healthy diet is,” said the lead author, Dr. Lea Borgi, an associate physician at Brigham and Women’s Hospital in Boston, “and I have no opinions about what people should eat. It’s important that studies like this continue the discussion.”

The Longer You Work, the Greater Your Risk for Heart Disease

Photo

Credit iStock

The more hours you work, the greater your risk for heart disease.

Several observational studies have found an association of long work hours with an increased risk for cardiovascular illness. Now a new retrospective analysis has found there is a dose-response relationship: more hours, more risk.

Researchers began following 1,926 men and women in 1986, tracking their health and work history through 2011. Over the course of the study, in the Journal of Occupational and Environmental Medicine, 822 were given diagnoses of cardiovascular disease.

After adjusting for age, sex, income and other factors, they found that for each additional hour of work per week over 10 years, there was a 1 percent increase in the risk for heart disease.

Compared with working 45 hours a week, working 55 hours increased the risk by 16 percent, 60 hours by 35 percent, 65 hours by 52 percent, and 70 hours by 74 percent. Working 75 hours or more doubled the risk for a cardiovascular problem — angina, coronary heart disease, hypertension, stroke or heart attack.

Still, the lead author, Sadie H. Conway, an assistant professor at the University of Texas School of Public Health, does not recommend that anyone alter work hours based on her study.

“I would never tell a person ‘don’t work long hours’ because of this risk, but it’s something that shouldn’t be ignored from a public health standpoint.”