Standalone sauna vs exercise followed by sauna on cardiovascular function in non‐naïve sauna users: A comparison of acute effects

Background and aimsSauna bathing and aerobic exercise have each been shown to affect cardiovascular function. However, direct comparisons between standalone sauna bathing and a combination of exercise and sauna on vascular indices remain limited. Therefore, we conducted a cross-over study using matched durations to explore the hemodynamic changes of sauna exposure when compared to a combination of aerobic exercise and sauna exposure.MethodsParticipants (N = 72) with at least one cardiovascular risk factor underwent, on two separate occasions: (a) a 30-minute sauna at 75°C (SAUNA) and (b) the combination of a 15-minute cycling exercise at 75% maximum heart rate followed by 15-minute sauna ex…

Heart failure risk reduction : is fit and overweight or obese better than unfit and normal weight?

This article refers to ‘Cardiorespiratory fitness, body mass index and heart failure incidence’ by P. Kokkinos et al., published in this issue on pages 436–444.

Physical activity may not be associated with long-term risk of dementia and Alzheimer's disease.

Background: While it is well established that physical activity is associated with reduced risk of vascular and non-vascular outcomes as well as mortality, evidence on the association between physical activity and dementia is inconsistent. We aimed to assess the associations of physical activity with the risk of dementia and Alzheimer’s disease (AD).Material and methods: We analysed data on 2,394 apparently healthy men with good baseline cognitive function from the prospective population-based Kuopio Ischaemic Heart Disease study. We assessed habits of physical activity at baseline using a 12-month leisure-time physical activity (LTPA) questionnaire. Using Cox regression, we calculated haza…

Sauna Bathing and Risk of Psychotic Disorders : A Prospective Cohort Study

<b><i>Objective:</i></b> Sauna bathing has been suggested to promote mental well-being and relaxation, but the evidence is uncertain with respect to mental disorders. We aimed to assess the association of frequency of sauna bathing with risk of psychosis in the Kuopio Ischemic Heart Disease prospective population-based study. <b><i>Subjects and Methods:</i></b> Baseline sauna bathing habits were assessed in 2,138 men aged 42–61 years who had no history of psychotic disorders. Participants were classified into three groups based on the frequency of sauna bathing (once, 2–3, and 4–7 times per week). <b><i>Results:</i></b>…

Leisure-time cross-country skiing and the risk of venous thromboembolism: A prospective cohort study

[No abstract]

Genetically elevated gamma-glutamyltransferase and Alzheimer's disease

Observational epidemiological evidence supports a linear and independent association between serum gamma-glutamyltransferase (GGT) concentrations and the risk of Alzheimer's disease (AD). However, the causality of this association has not been previously investigated. We sought to assess the causal nature of this association using a Mendelian randomization (MR) approach. Using inverse-variance weighted MR analysis, we assessed the association between GGT and AD using summary statistics for single nucleotide polymorphism (SNP)-AD associations obtained from the International Genomics of Alzheimer's Project of 17,008 individuals with AD and 37,154 controls. We used 26 SNPs significantly associ…

Handgrip strength is inversely associated with fatal cardiovascular and all-cause mortality events

Purpose: We aimed to assess the associations of handgrip strength (HS) with cardiovascular and all-cause mortality and whether adding data on HS to cardiovascular disease (CVD) risk factors is associated with improvement in CVD mortality prediction. Design: Handgrip strength was assessed in a population-based sample of 861 participants aged 61–74 years at baseline. Relative HS was obtained by dividing the absolute value by body weight. Results: During a median (interquartile range) follow-up of 17.3 (12.6–18.4) years, 116 fatal coronary heart diseases (CHDs), 195 fatal CVDs and 412 all-cause mortality events occurred. On adjustment for several risk factors, the hazard ratios (95% confidence…

Ideal cardiovascular health and risk of acute myocardial infarction among Finnish men

Background and aims: Acute myocardial infarction (AMI) is associated with high mortality globally and remains a public health burden. We sought to investigate the relation between the American Heart Association’s cardiovascular health metrics (CVH) and the risk of AMI among middle-aged Finnish men. Methods: We used the ongoing population-based Kuopio Ischaemic Heart Disease cohort study comprising men aged 40 to 62 years at baseline. The CVH metrics was computed among 2584 participants at baseline with health scores ranging from 0 to 7. This was categorized into three groups of CVH metrics as poor (0-2), intermediate (3-4) and ideal (≥5). Multivariate Cox regression models were used to esti…

Cardiovascular complications in COVID-19:A systematic review and meta-analysis

Cardiorespiratory fitness is not associated with risk of venous thromboembolism: a cohort study

Objectives. The inverse and independent association between cardiorespiratory fitness (CRF) and arterial thrombotic disease is well established. However, the potential association between CRF and venous thromboembolism (VTE) is not well known. We aimed to assess the prospective association of CRF with the risk of VTE. Design. Cardiorespiratory fitness, as measured by maximal oxygen uptake (VO2max), was assessed using a respiratory gas exchange analyser in 2,249 men aged 42-61 years without a history of VTE at baseline in the Kuopio Ischemic Heart Disease prospective cohort. Cox-regression models were used to calculate hazard ratios (HR) with 95% confidence interval (CI) for VTE. We correcte…

Handgrip strength is not associated with risk of venous thromboembolism: a prospective cohort study.

Objectives. Consistent evidence suggests an inverse and independent association between handgrip strength and arterial thrombotic disease. However, whether handgrip strength is related to future risk of venous thromboembolism (VTE) is uncertain. We sought to assess the prospective association between handgrip strength and VTE risk. Design. Handgrip strength was assessed using a hand dynamometer in a population-based sample of 864 men and women aged 61–74 years without a history of VTE at baseline in the Kuopio Ischemic Heart Disease prospective cohort study. Handgrip strength was allometrically scaled to account for the effect of body weight (handgrip strength/body weight2/3) and to normali…

Sauna bathing is associated with reduced cardiovascular mortality and improves risk prediction in men and women: a prospective cohort study.

Background Previous evidence indicates that sauna bathing is related to a reduced risk of fatal cardiovascular disease (CVD) events in men. The aim of this study was to investigate the relationship between sauna habits and CVD mortality in men and women, and whether adding information on sauna habits to conventional cardiovascular risk factors is associated with improvement in prediction of CVD mortality risk. Methods Sauna bathing habits were assessed at baseline in a sample of 1688 participants (mean age 63; range 53–74 years), of whom 51.4% were women. Multivariable-adjusted hazard ratios (HRs) were calculated to investigate the relationships of frequency and duration of sauna use with C…

Cross-Country Skiing and Running’s Association with Cardiovascular Events and All-Cause Mortality:A Review of the Evidence

A large body of evidence demonstrates positive, graded effects of PA on cardiovascular disease (CVD) morbidity and mortality with increasing intensity compared with lower PA intensity. Running is often designated as a high-intensity PA with substantial evidence supporting its health benefits. Cross-country skiing is among the most demanding aerobic endurance exercises and requires engaging the upper- and lower-body. Cross-country skiing is often regarded as high-intensity PA, which has been associated with significant health benefits. However, a robust body of evidence identifying the dose-response relation between cross-country skiing volume and health outcomes is sparse. Therefore, this r…

Heart failure risk reduction:hydrophilic or lipophilic statins?

[No abstract]

Leisure-time cross-country skiing and risk of atrial fibrillation and stroke:a prospective cohort study

[No Abstract]

Leisure-time cross-country skiing is associated with lower incidence of hypertension:A prospective cohort study

Abstract Objective: The prospective relationship between cross-country skiing and hypertension is uncertain. We aimed to assess the associations of leisure time cross-country skiing habits with incident hypertension in a general population. Methods: The frequency, average duration, and intensity of leisure cross-country skiing were assessed at baseline using a 12-month physical activity questionnaire in the Kuopio Ischemic Heart Disease prospective study of 1809 middle-aged men without hypertension. Hazard ratios [95% confidence intervals (CIs)] were calculated. Results: New onset diagnosis of hypertension was observed in 279 participants during a median (interquartile range) follow-up of 2…

American Heart Association’s Cardiovascular Health Metrics and Risk of Cardiovascular Disease Mortality Among a Middle-aged Male Scandinavian Population

Background: The burden of cardiovascular disease (CVD) prompted the American Heart Association to develop a cardiovascular health (CVH) metric as a measure to assess the cardiovascular status of the population. We aimed to assess the association between CVH scores and the risk of CVD mortality among a middle-aged Finnish population. Methods: We employed the prospective population-based Kuopio Ischemic Heart Disease cohort study comprising of middle-aged men (42–60 years). CVH scores were computed among 2607 participants at baseline and categorized as optimum (0–4), average (5–9), or inadequate (10–14) CVH. Multivariate cox regression models were used to estimate the hazard ratios (HR) and 9…

Sauna bathing reduces the risk of stroke in Finnish men and women : A prospective cohort study

ObjectiveTo assess the association between frequency of sauna bathing and risk of future stroke.MethodsBaseline habits of sauna bathing were assessed in 1,628 adult men and women aged 53–74 years (mean age, 62.7 years) without a known history of stroke in the Finnish Kuopio Ischemic Heart Disease prospective cohort study. Three sauna bathing frequency groups were defined: 1, 2–3, and 4–7 sessions per week. Hazard ratios (HRs) (95% confidence intervals [CIs]) were estimated for incident stroke.ResultsDuring a median follow-up of 14.9 years, 155 incident stroke events were recorded. Compared with participants who had one sauna bathing session per week, the age- and sex-adjusted HR (95% CI) fo…

Leisure-time cross-country skiing is associated with lower incidence of type 2 diabetes:A prospective cohort study

Background Cross-country skiing is associated with reduction in risk of adverse vascular outcomes, but its association with type 2 diabetes is uncertain. We aimed to assess the associations between leisure-time cross-country skiing habits and incident type 2 diabetes. Methods We analysed the data of 2483 middle-aged men with no history of diabetes at baseline in the Kuopio Ischemic Heart Disease prospective study. The frequency, average duration, and intensity of leisure cross-country skiing were assessed at baseline using a 12-month physical activity questionnaire. Hazard ratios (HRs) (95% CIs) for type 2 diabetes were estimated. Results During a median follow-up of 21.6 years, 539 men dev…

Is sauna bathing protective of sudden cardiac death? A review of the evidence

Sudden cardiac death (SCD) is a global public health burden accounting for 15–20% of all deaths. Though established atherosclerotic risk factors explain a large proportion of the risk of SCD, these factors are often absent in a large proportion of SCD victims and the pathogenesis of SCD is still not fully established. It therefore appears that additional factors may be involved. Sauna bathing is a traditional Finnish activity that is mainly used for the purposes of relaxation and pleasure. Beyond its use for these purposes, sauna bathing has been linked with several health benefits. Emerging evidence suggests that sauna bathing is associated with reduced risk of adverse cardiovascular (CV) …

Physical activity and risk of venous thromboembolism: systematic review and meta-analysis of prospective cohort studies

The inverse association between physical activity and arterial thrombotic disease is well established. Evidence on the association between physical activity and venous thromboembolism (VTE) is divergent. We conducted a systematic review and meta-analysis of published observational prospective cohort studies evaluating the associations of physical activity with VTE risk. MEDLINE, Embase, Web of Science, and manual search of relevant bibliographies were systematically searched until 26 February 2019. Extracted relative risks (RRs) with 95% confidence intervals (CIs) for the maximum versus minimal amount of physical activity groups were pooled using random effects meta-analysis. Twelve article…

Effect of Cardiorespiratory Fitness on Risk of Sudden Cardiac Death in Overweight/Obese Men Aged 42 to 60 Years

The purpose of this study was to examine the subject and combined associations of cardiorespiratory fitness (fitness) and body mass index (BMI) with the risk of sudden cardiac death (SCD) in middle-aged men. This prospective study was based on a population sample of 2,357 men aged 42 to 60 years, who were followed up in the Kuopio Ischemic Heart Disease cohort study. Fitness was directly measured by peak oxygen uptake (VO2peak) during progressive exercise testing to volitional fatigue. Participants were divided into 4 groups (fit-normal weight, unfit-normal weight, fit-overweight/obese, and unfit-overweight/obese) based on the median values of fitness and BMI. A total of 253 (10.7%) SCDs oc…

Acute effects of exercise and sauna as a single intervention on arterial compliance

Cardiovascular and Other Health Benefits of Sauna Bathing:A Review of the Evidence

Sauna bathing, an activity that has been a tradition in Finland for thousands of years and mainly used for the purposes of pleasure and relaxation, is becoming increasingly popular in many other populations. Emerging evidence suggests that beyond its use for pleasure, sauna bathing may be linked to several health benefits, which include reduction in the risk of vascular diseases such as high blood pressure, cardiovascular disease, and neurocognitive diseases; nonvascular conditions such as pulmonary diseases; mortality; as well as amelioration of conditions such as arthritis, headache, and flu. The beneficial effects of sauna bathing on these outcomes have been linked to its effect on circu…

Sleep Duration and Risk of Fatal Coronary Heart Disease, Sudden Cardiac Death, Cancer Death, and All-Cause Mortality

Background: Sleep duration has been shown to be associated with all-cause mortality, however its relationship with cause-specific fatal events remains uncertain. We examined the relationship between sleep duration and risk of fatal coronary heart disease (CHD), sudden cardiac death, cancer related death and all-cause mortality. Methods Sleep duration was self-reported at baseline examinations performed between March 20, 1984 and December 5, 1989 in 2,361 men aged 42-61 years old from the Kuopio Ischemic Heart Disease study. Of these 1734 (73.4%) men were free from CHD and cancer at baseline. Results: A total of 802 all cause deaths, 202 fatal coronary heart disease events, 141 sudden cardia…

A potential case for the routine assessment of cardiorespiratory fitness level in clinical practice

Short-term effects of Finnish sauna bathing on blood-based markers of cardiovascular function in non-naive sauna users

Emerging evidence suggests that sauna bathing is associated with reduced risk of cardiovascular and all-cause mortality events. However, the biochemical pathways by which sauna bathing might confer its effects on cardiovascular function are not certain. We aimed to study the acute effects of Finnish sauna bathing on various blood-based cardiovascular biomarkers. The study included 102 non-naive sauna users (54% male) with mean age of 51.9 years, who had at least one cardiovascular risk factor. Participants underwent a 30-min single sauna session (mean temperature, 73 °C). Biochemical profiling was conducted before, immediately after sauna and 30-min post-sauna. Overall median N-terminal pro…

Combined Effect of Sauna Bathing and Cardiorespiratory Fitness on the Risk of Sudden Cardiac Deaths in Caucasian Men: A Long-term Prospective Cohort Study

Both cardiorespiratory fitness (CRF) and frequency of sauna bathing (FSB) are each strongly and independently associated with sudden cardiac death (SCD) risk. However, the combined effect of CRF and FSB on SCD risk has not been previously investigated. We evaluated the joint impact of CRF and FSB on the risk of SCD in the Kuopio Ischemic Heart Disease prospective cohort study of 2291 men aged 42-61 years at recruitment. Objectively measured CRF and self-reported sauna bathing habits were assessed at baseline. CRF was categorized as low and high (median cutoffs) and FSB as low and high (defined as ≤2 and 3-7 sessions/week respectively). Multivariable adjusted hazard ratios (HRs) with confide…

Association between ideal cardiovascular health and risk of sudden cardiac death and all-cause mortality among middle-aged men in Finland.

Abstract Background Strong associations have been demonstrated between the American Heart Association’s cardiovascular health (CVH) metrics and various cardiovascular outcomes, but the association with sudden cardiac death (SCD) is uncertain. We examined the associations between these CVH metrics and the risks of SCD and all-cause mortality among men in Finland. Methods and results We used the prospective population-based Kuopio Ischaemic Heart Disease cohort study, which consists of men between 42 and 60 years of age at baseline. CVH metrics were computed for 2577 men with CVH scores at baseline ranging from 0 to 7, categorized into CVH scores of 0–2 (poor), 3–4 (intermediate) and 5–7 (ide…

Should inflammatory pathways be targeted for the prevention and treatment of hypertension?

Hypertension is the most common modifiable risk factor for cardiovascular disease (CVD)1 and is a leading cause of death globally.2 Hypertension and CVD share common antecedent risk factors which include physical inactivity, obesity and excess alcohol intake.3 Though these established risk factors explain a large proportion of hypertension risk, its pathogenesis is still not fully established as it appears that other additional lifestyle and genetic factors may be involved. There is therefore a need to identify and evaluate putative risk factors that may increase our knowledge of hypertension development, may have causal or predictive relevance, and which will help develop preventive and ma…

Investigation of antihypertensive class, dementia, and cognitive decline: a meta-analysis

ObjectiveHigh blood pressure is one of the main modifiable risk factors for dementia. However, there is conflicting evidence regarding the best antihypertensive class for optimizing cognition. Our objective was to determine whether any particular antihypertensive class was associated with a reduced risk of cognitive decline or dementia using comprehensive meta-analysis including reanalysis of original participant data.MethodsTo identify suitable studies, MEDLINE, Embase, and PsycINFO and preexisting study consortia were searched from inception to December 2017. Authors of prospective longitudinal human studies or trials of antihypertensives were contacted for data sharing and collaboration.…

Recovery from sauna bathing favorably modulates cardiac autonomic nervous system

Objective: Sauna bathing is becoming a common activity in many countries and it has been linked to favorable health outcomes. However, there is limited data on the heart rate (HR) and heart rate variability (HRV) responses to an acute sauna exposure. Design: We conducted a single-group, longitudinal study utilizing a pre-post design to examine acute effects of sauna bathing on the autonomic nervous system as reflected by HRV. A total of 93 participants (mean [SD] age: 52.0 [8.8] years, 53.8% males) with cardiovascular risk factors were exposed to a single sauna session (duration: 30 min; temperature: 73 °C; humidity: 10–20%) and data on HRV variables were collected before, during and after …

Cross-country skiing and the risk of acute myocardial infarction: A prospective cohort study

Does cardiorespiratory fitness really influence venous thromboembolism risk?

[No Abstract]

Relative peak exercise oxygen pulse is related to sudden cardiac death, cardiovascular and all-cause mortality in middle-aged men

Background Preliminary evidence suggests that peak exercise oxygen pulse – peak oxygen uptake/heart rate-, a variable obtained during maximal cardiopulmonary exercise testing and a surrogate of stroke volume, is a predictor of mortality. We aimed to assess the associations of peak exercise oxygen pulse with sudden cardiac death, fatal coronary heart disease and cardiovascular disease and all-cause mortality. Design A prospective study. Methods Peak exercise oxygen pulse was assessed in a maximal cycling test at baseline in 2227 middle-aged men of the Kuopio Ischaemic Heart Disease cohort study using expired gas variables and electrocardiograms. Relative peak exercise oxygen pulse was obtain…

Prognostic Relevance of Cardiorespiratory Fitness as Assessed by Submaximal Exercise Testing for All-Cause Mortality: A UK Biobank Prospective Study

Objective: To investigate if the inverse associations of cardiorespiratory fitness (CRF) with all-cause and cardiovascular mortality in the general population vary among individuals who are at different pre-test risk. Patients and Methods: CRF was assessed through submaximal bike tests in 58,892 participants aged 40-69 years who completed baseline questionnaires between January 1, 2006 and December 31, 2010 in the UK Biobank study. Participants were categorized into risk categories, which determined allocation to an individualized bike protocol. These were “minimal risk (1)”, “small risk (2)” and “medium risk (3)” groups (i.e., those who cycled at 50%, 35% of predicted maximal workload and …

Physical activity and risk of atrial fibrillation in the general population : meta-analysis of 23 cohort studies involving about 2 million participants

Regular physical activity is well established to be associated with reduced risk of cardiovascular disease outcomes. Whether physical activity is associated with the future risk of atrial fibrillation (AF) remains a controversy. Using a systematic review and meta-analysis of published observational cohort studies in general populations with at least one-year of follow-up, we aimed to evaluate the association between regular physical activity and the risk of AF. Relevant studies were sought from inception until October 2020 in MEDLINE, Embase, Web of Science, and manual search of relevant articles. Extracted relative risks (RRs) with 95% confidence intervals (CIs) for the maximum versus the …

TV viewing and venous thromboembolism: Risk or red herring?

[No abstract]

Lipoprotein(a) is not associated with venous thromboembolism risk.

Objectives. Evidence from case-control studies as well as meta-analyses of these study designs suggest elevated lipoprotein(a) [Lp(a)] to be associated with an increased risk of venous thromboembolism (VTE). Prospective evidence on the association is limited, uncertain, and could be attributed to regression dilution bias. We aimed to assess the prospective association of Lp(a) with risk of VTE and correct for regression dilution. Design. We related plasma Lp(a) concentrations to the incidence of VTE in 2,180 men of the Kuopio Ischemic Heart Disease cohort study. Hazard ratios (HRs) (95% confidence intervals [CI]) were assessed and repeat measurements of Lp(a) at 4 and 11 years from baseline…

In reply : Sauna Bathing and Healthy Sweating

Is 're-calibration' of standard cardiovascular disease (CVD) risk algorithms the panacea to improved CVD risk prediction and prevention?

This editorial refers to ‘Equalization of four cardiovascular risk algorithms after systematic recalibration: individual-participant meta-analysis of 86 prospective studies’, by L. Pennells et al., doi:10.1093/eurheartj/ehy653.

Serum Albumin and Future Risk of Hip, Humeral, and Wrist Fractures in Caucasian Men:New Findings from a Prospective Cohort Study

<b><i>Objective:</i></b> Low serum albumin concentration is associated with poor health outcomes, but its relationship with the risk of fractures has not been reliably quantified. We aimed to assess the prospective association of serum albumin with the risk of fractures in a general population. <b><i>Subjects and Methods:</i></b> Baseline serum albumin concentrations were measured in 2,245 men aged 42–61 years in the Kuopio Is­chemic Heart Disease study. Hazard ratios (HRs) (95% confidence intervals) were calculated for incident fractures. <b><i>Results:</i></b> A total of 121 fractures (hip, humeral, or wrist) were rec…

Association between estimated pulse wave velocity and the risk of cardiovascular outcomes in men.

[No Abstract]

Sauna exposure leads to improved arterial compliance: Findings from a non-randomised experimental study.

Background Heat therapy has been suggested to improve cardiovascular function. However, the effects of hot sauna exposure on arterial compliance and the dynamics of blood flow and pressure have not been well documented. Thus, we investigated the short-term effects of sauna bathing on arterial stiffness and haemodynamics. Design The design was an experimental non-randomised study. Methods There were 102 asymptomatic participants (mean age, 51.9 years) who had at least one cardiovascular risk factor. Participants were exposed to a single sauna session (duration: 30 min; temperature: 73℃; humidity: 10–20%). Pulse wave velocity, augmentation index, heart rate, blood pressure, mean arterial pres…

Impact of Cardiorespiratory Fitness on Survival in Men with Low Socioeconomic Status

Abstract Aims Although both low socioeconomic status (SES) and poor cardiorespiratory fitness (CRF) are associated with increased chronic disease and heightened mortality, it remains unclear whether moderate-to-high levels of CRF are associated with survival benefits in low SES populations. This study evaluated the hypothesis that SES and CRF predict all-cause mortality and cardiovascular disease mortality and that moderate-to-high levels of CRF may attenuate the association between low SES and increased mortality. Methods This study included 2368 men, who were followed in the Kuopio Ischaemic Heart Disease Study cohort. CRF was directly measured by peak oxygen uptake during progressive exe…

The Duke treadmill score with bicycle ergometer: Exercise capacity is the most important predictor of cardiovascular mortality

Background The Duke treadmill score, a widely used treadmill testing tool, is a weighted index combining exercise time or capacity, maximum ST-segment deviation and exercise-induced angina. No previous studies have investigated whether the Duke treadmill score and its individual components based on bicycle exercise testing predict cardiovascular death. Design Two populations with a standard bicycle testing were used: 3936 patients referred for exercise testing (2371 men, age 56 ± 13 years) from the Finnish Cardiovascular Study (FINCAVAS) and a population-based sample of 2683 men (age 53 ± 5.1 years) from the Kuopio Ischaemic Heart Disease study (KIHD). Methods Cox regression was applied for…

Marriage Dissatisfaction and the Risk of Sudden Cardiac Death Among Men

Conflicts in marriage have been associated with potential risk of cardiovascular disease; however, there is lack of prospective evidence on the association between marriage satisfaction and sudden cardiac death (SCD). We aimed to assess the association between perceived level of marriage satisfaction and risk of SCD. This study employed the Kuopio Ischemic Heart Disease study, an ongoing prospective population-based study in Finland. Perceived level of marriage satisfaction was assessed in 2,262 men using a well-structured self-administered questionnaire. Multivariable adjusted Cox regression models were used to estimate hazard ratios (95% confidence interval [CI]) for SCD. During a median …

Cardiorespiratory Fitness and the Risk of Serious Ventricular Arrhythmias: A Prospective Cohort Study.

Cardiorespiratory fitness (CRF) is an established risk factor for cardiovascular disease outcomes. However, the relationship of CRF with risk of ventricular arrhythmias (VAs) is unknown. We aimed to assess the prospective association of CRF with the risk of serious VAs. Cardiorespiratory fitness, as measured by maximal oxygen uptake, was assessed using a respiratory gas exchange analyzer in 2299 middle-aged men in the Kuopio Ischemic Heart Disease prospective cohort. We corrected for within-person variability in CRF levels using data from repeated measurements 11 years apart. During median follow-up of 25.3 years (interquartile range, 18.7-27.2 years), 73 serious VAs were recorded. The age-…

Response to letter by Peng-Wu and Ma on: the relationship of cardiorespiratory fitness and venous thromboembolism: yes or no?

Sir,We thank Peng-Wu and Ma for their letter [1] regarding our recently published article [2]. Their concern is that our findings cannot be generalized because it was based on only men and conducte...