This study investigated the associations of cardiorespiratory fitness (CRF) and different measures of adiposity with cardiovascular disease (CVD) and all-cause mortality in men. Data from men with documented or suspected coronary heart disease (CHD) in the Aerobics Center Longitudinal Study (N = 9,563) were analyzed using baseline body mass index (BMI), CRF (quantified as the duration of a symptom-limited maximal treadmill exercise test), waist circumference (WC), and percent body fat (BF). After adjustment for age, examination year, and multiple baseline risk factors, men with low fitness had a higher risk of all-cause mortality in the BMI categories of normal weight (hazard ratio [HR] 1.60; 95% CI 1.24-2.05), obese class I (HR 1.38; 95% CI 1.04-1.82), and obese class II/III (HR 2.43; 95% CI 1.55-3.80) but not overweight compared with the normal-weight and high-fitness reference group. A similar pattern was noted for WC and percent BF tertiles and for CVD mortality. Among men with high fitness, there were no significant differences in CVD and all-cause mortality risk across BMI, WC, and percent BF categories. Therefore, using adiposity to assess mortality risk in patients with CHD may be misleading unless fitness is considered. Mayo Clin Proc. 2012 Apr 11. PMID: 22503065
