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Background  Good cardiorespiratory fitness has been associated with reduced risk for clinical events of atherosclerotic vascular diseases, but whether it is related to slower progression of early atherosclerosis is unclear. Objective: To study the association between cardiorespiratory fitness and the progression of early carotid atherosclerosis. Design: 4-year follow-up study. Setting: Eastern Finland. Participants: Population-based sample of 854 men 42 to 60 years of age. Measurements: Maximal oxygen uptake (VO 2 max [L/kg per minute]) was measured directly by using respiratory gas exchange in a cycle ergometer exercise test. Carotid atherosclerosis was assessed by using B-mode ultrasonography. Results: After adjustments for age, technical covariates, and cigarette smoking, VO 2 max had strong, inverse, and graded associations with 4-year increases i maximal intima-media thickness (IMT) (standard regression coefficient β = 0.120; P = 0.002); plaque height (β = 0.140; P   36.2 ML/kg per minute). Conclusions: Good cardiorespiratory fitness is associated with slower progression of early atherosclerosis in middle-aged men. These findings are important because they emphasize that middle-aged men can be evaluated for cardiorespiratory fitness to estimate their future risk for atherosclerotic vascular disease. Additional research is warranted to investigate a possible causal relationship between cardiorespiratory fitness and atherosclerosis.

Cardiorespiratory fitness and the progression of carotid atherosclerosis in middle-aged men. Ann Intern Med 134:12–20, 2001