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Lack of Exercise Hurts Women More
Poor Physical Fitness Raises Death Risk for Women More Than Men
Sept. 15, 2003 -- Not getting enough exercise may be even more dangerous for women than men.
A new study shows that poor physical fitness raises the risk of death even higher among women than men.
Researchers say the results suggest that a person's physical fitness level may be a more accurate predictor of death risk than other commonly used measures that are based on sex, cholesterol, age, blood pressure, and smoking status.
"Heart and blood vessel disease is the No. 1 killer of both men and women. Earlier studies showed an association between poor exercise capacity and poor survival in men with or without heart disease, but this is the first study large enough to examine the issue in a cross-section of healthy women," says researcher Martha Gulati, MD, MS, an assistant professor of medicine and preventive medicine at Rush Presbyterian St. Luke's Medical Center in Chicago, in a news release.
Poor Physical Fitness Raises Risks
In the study, researchers followed 5,721 women with an average age of 52 from 1992 until 2000. None of the women had heart disease, but many of them had high blood pressure, high cholesterol, diabetes, or other risk factors for heart disease.
Each of the women completed a physical fitness test on a treadmill, which measured their exercise capacity in metabolic equivalents (METs), at the start of the study.
Researchers found that for every 1 MET increase in exercise capacity at the beginning of the study there was a 17% decrease in the risk of death over the next eight years.
The risk of death doubled for those women with reduced fitness in the medium range of physical fitness (5 MET to 8 MET range) and the risk of death tripled for women in the lowest category of fitness compared with those in the highest (above 8 METs).
Researchers say that a similar study among men found a 7.9% decrease in death risk for men for each one-minute increase in exercise time, which is roughly equivalent to a MET.
Researchers Call for More Physical Fitness Testing
"Currently, no one recommends routine exercise testing in healthy individuals. Our study has demonstrated a clear clinical rationale for routine stress testing in asymptomatic women," says Gulati.
"This is one of the most important public health issues, and we've got to start attacking it," she says.
In an editorial that accompanies the study, Daniel B. Mark, MD, MPH, and Michael S. Lauer, MD, of the Duke Clinical Research Institute in Durham, N.C., write that this study provides "the most unambiguous evidence to date" of the value of exercise in predicting heart-related death risk. But they stop short of recommending widespread physical fitness testing.
They write that this and other studies clearly imply that improving exercise capacity will improve the outlook for patients, but that hypothesis hasn't adequately been tested. The editorialists write that a randomized, controlled study is needed to answer that question.

SOURCES: Gulati, M. Circulation: Journal of the American Heart Association, Sept. 30, 2003. News release, American Heart Association.