{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T04:04:06Z","timestamp":1788494646761,"version":"build-2803163510"},"reference-count":29,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,5,19]]},"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine the association between submaximal cardiorespiratory fitness (sCRF) and all-cause mortality in a cardiac rehabilitation (CR) cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study of participants entering CR between 26 May 1993 and 16 October 2006, followed up to 1 November 2013 (median 14\u2005years, range 1.2\u201319.4\u2005years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A community-based CR exercise programme in Leeds, West Yorkshire, UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A cohort of 534 men (76%) and 136 women with a clinical diagnosis of coronary heart disease (CHD), aged 22\u201382\u2005years, attending CR were evaluated for the association between baseline sCRF and all-cause mortality. 416 participants with an exercise test following CR (median 14\u2005weeks) were examined for changes in sCRF and all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>All-cause mortality and change in sCRF expressed in estimated metabolic equivalents (METs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Baseline sCRF was a strong predictor of all-cause mortality; compared to the lowest sCRF group (&lt;5 METs for women and &lt;6 METs for men), mortality risk was 41% lower in those with moderate sCRF (HR 0.59; 95% CI 0.42 to 0.83) and 60% lower (HR 0.40; 95% CI 0.25 to 0.64) in those with higher sCRF levels (\u22657 METs women and \u22658 METs for men). Although improvement in sCRF at 14\u2005weeks was not associated with a significant mortality risk reduction (HR 0.91; 95% CI 0.79 to 1.06) for the whole cohort, in those with the lowest sCRF (and highest all-cause mortality) at baseline, each 1-MET improvement was associated with a 27% age-adjusted reduction in mortality risk (HR 0.73; 95% CI 0.57 to 0.94).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher baseline sCRF is associated with a reduced risk of all-cause mortality over 14\u2005years in adults with CHD. Improving fitness through exercise-based CR is associated with significant risk reduction for the least fit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-011125","type":"journal-article","created":{"date-parts":[[2016,6,30]],"date-time":"2016-06-30T23:03:47Z","timestamp":1467327827000},"page":"e011125","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Submaximal fitness and mortality risk reduction in coronary heart disease: a retrospective cohort study of community-based exercise rehabilitation"],"prefix":"10.1136","volume":"6","author":[{"given":"Claire","family":"Taylor","sequence":"first","affiliation":[{"name":"Department of Sport, Health and Exercise Science, University of Hull, Hull, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costas","family":"Tsakirides","sequence":"additional","affiliation":[{"name":"Carnegie School of Sport, Leeds Beckett University, 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