Prevention & lipidsCohort study
Cardiorespiratory fitness and population attributable risk: the ETHOS study
- Retrospective cohort study
- Veterans Administration cohort
- nested models
Authors' conclusion
Low CRF and hypertension were the strongest predictors of mortality and accounted for the greatest proportion of population-level risk.
Study context
- Population
- Veterans undergoing maximal exercise testing; mean age 65.1±9.7 years; follow-up 10.2±5.1 years
- Participants
- 580,290 veterans
- Exposure
- Low cardiorespiratory fitness (CRF) vs other major risk factors
- Outcome
- Mortality (relative risks (RRs), population attributable risks (PARs) and exposure impact numbers (EINs) for low CRF and other major risk factors)
- Follow-up
- 10.2±5.1 years
Main finding
As reported in the abstract
Mortality
PAR, hypertension (greatest population-level impact)
21.8% (95% CI 15.2-28.0)
PAR, low CRF
14.7% (95% CI 8.1-21.1)
Observational data: associations, not effects.
Further findings
| Outcome | RR (95% CI) | |
|---|---|---|
| Mortality, fully adjusted sensitivity analysis — Low CRF vs Lowest CRF quintile · strongest independent association · sensitivity analysis | 1.77 (1.75–1.79) | |
| Mortality, fully adjusted sensitivity analysis — Hypertension vs Lowest CRF quintile · sensitivity analysis | 1.33 (1.32–1.35) | |
| 0.512Relative risk (log scale) |
Exposure impact number
- Absolute EIN lowest for low CRF
- 2.36
- Per 100 individuals whose fitness improved, approximately 24 fewer deaths expected
Original publication
Cardiorespiratory fitness and population attributable risk: the ETHOS study. Eur J Prev Cardiol. Published 4 September 2026. doi:10.1093/eurjpc/zwag471
Summarised from the published abstract; every number is checked against it