Fitness Resources

Month: June 2019

Men’s Health Month: Improving cardiorespiratory fitness reduces heart failure mortality

Written by
Steve Farrell, PhD, FACSM

Posted in

Wednesday, Jun 05, 2019

June is Men’s Health Month, which is a great opportunity to raise awareness about the importance of preventive health care for men.

When you look at the statistics from the Centers for Disease Control (CDC), it looks grim. Women are 100% more likely than men to visit the doctor for annual exams and other preventive health care measures. Men die at higher rates than women from 9 of the top 10 causes of death and die an average of 5 years earlier than women.

The number one cause of death is still heart disease, which can largely be prevented, or at least delayed by making positive lifestyle choices such as eating healthy, not smoking, and getting more physical activity. We know after decades of research that increasing physical activity to improve aerobic fitness is key to living a longer, healthier life.

Nearly 6 million Americans are living with heart failure, a condition where the heart’s ability to pump and fill properly steadily declines. Heart failure is the leading cause of hospitalization in the U.S. for individuals ages 65 and older, and accounts for nearly 60,000 deaths annually. Well-established risk factors for heart failure include hypertension, diabetes, age, obesity, smoking, heart valve disease, previous heart attack, and family history.   

A sedentary lifestyle is another known risk factor for heart failure, but previous studies focused solely on self-reported physical activity levels. The problem is that self-reported studies of physical activity usually come from a questionnaire and are not an objective measurement of physical fitness. In fact, the self-report numbers can be quite different from the reality of a true fitness assessment. This is why studies from the Cooper Center Longitudinal Study (CCLS) are so important. The CCLS is the largest and longest-running study in the world that uses measured fitness rather than self-reports of activity.

A CCLS study by researchers at The Cooper Institute shows that baseline levels of cardiorespiratory fitness are strongly predictive of future risk of heart failure mortality. Results from the study showed:

  • Moderate and low fit men were 1.63 and 3.97 times more likely to die from heart failure, respectively, compared to those in the high fit category.
  • Unfit men with no heart failure risk factors were 2.5 times more likely to die from heart failure than fit men with no risk factors. The same trend was seen in men with any one, two or more risk factors.
  • Fit men were substantially less likely to die from heart failure than unfit men, regardless of the number of heart failure risk factors present.

The authors concluded that low levels of cardiorespiratory fitness are a powerful and independent risk factor for heart failure mortality. The recommendation is that all men should consider annual checkups and be counseled on physical activity by their health care provider, with the goal of achieving at least a moderate level of cardiorespiratory fitness in order to reduce risk of heart failure mortality.

But this doesn’t just apply to men. All adults can do more to reduce the risk of heart failure and heart disease death with these tips:

  • Monitor and control your blood pressure if you have hypertension.
  • Control your blood glucose level if you have diabetes.
  • Avoid obesity. Lose weight if you are overweight.
  • Avoid tobacco in all forms.
  • Avoid a sedentary lifestyle. Aim for at least a moderate level of cardiorespiratory fitness.
  • Eat more unrefined plant-based foods, such as fruits, vegetables, whole grains, raw nuts, seeds, and legumes and increase your intake of reduced-fat dairy.

Everyone is encouraged to meet the current public health guidelines for aerobic activity. The guidelines recommend a minimum of 150 minutes per week of moderate-intensity aerobic activity, but don’t be afraid to hold back. Exceeding these guidelines is very likely to result in higher fitness levels, further decreasing the risk of heart failure mortality.


Farrell, S., Finley, C., Radford, and Haskell, W. (2013). Cardiorespiratory fitness, body mass index, and heart failure mortality in men: Cooper Center Longitudinal Study. Circulation:Heart Failure, 6:898-905. Doi: 10. 1161/CIRHEARTFAILURE.112.000088.

Blumenthal, J. et al. (2010). Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure. Arch Intern Med, 170(2), 126-134.