{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T23:33:29Z","timestamp":1772667209896,"version":"3.50.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T00:00:00Z","timestamp":1580688000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T00:00:00Z","timestamp":1580688000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Ministry of Education of the Republic of Korea and the National Research Foundation of Korea","award":["NRF-2016 S1A 5A2A 03928101"],"award-info":[{"award-number":["NRF-2016 S1A 5A2A 03928101"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,5,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>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 exercise testing. SES was characterized using self-reported questionnaires.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>During a 25-year median follow-up, 1116 all-cause mortality and 512 cardiovascular disease mortality events occurred. After adjusting for potential confounders, men with low SES were at increased risks for all-cause mortality (hazard ratio 1.49, 95% confidence interval: 1.30\u20131.71) and cardiovascular disease mortality (hazard ratio1.38, 1.13\u20131.69). Higher levels of CRF were associated with lower risks of all-cause mortality (hazard ratio 0.54, 0.45\u20130.64) and cardiovascular disease mortality (hazard ratio 0.53, 0.40\u20130.69). In joint associations of SES and CRF with mortality, low SES-unfit had significantly higher risks of all-cause mortality (hazard ratio 2.15, 1.78\u20132.59) and cardiovascular disease mortality (hazard ratio 1.95, 1.48-2.57), but low SES-fit was not associated with a heightened risk of cardiovascular disease mortality (hazard ratio 1.09, 0.80-1.48) as compared with their high SES-fit counterparts.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Both SES and CRF were independently associated with subsequent mortality; however, moderate-to-high levels of CRF were not associated with an excess risk of cardiovascular disease mortality in men with low SES.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1177\/2047487319901057","type":"journal-article","created":{"date-parts":[[2020,2,4]],"date-time":"2020-02-04T04:45:38Z","timestamp":1580791538000},"page":"450-455","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":29,"title":["Impact of cardiorespiratory fitness on survival in men with low socioeconomic status"],"prefix":"10.1093","volume":"28","author":[{"given":"Sae Young","family":"Jae","sequence":"first","affiliation":[{"name":"Department of Sport Science, University of Seoul, Republic of Korea"},{"name":"Division of Urban Social Health, Graduate School of Urban Public Health, University of Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sudhir","family":"Kurl","sequence":"additional","affiliation":[{"name":"Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanokwan","family":"Bunsawat","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Geriatrics, University of Utah, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barry A","family":"Franklin","sequence":"additional","affiliation":[{"name":"Preventive Cardiology and Cardiac Rehabilitation, William Beaumont Hospital, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jina","family":"Choo","sequence":"additional","affiliation":[{"name":"College of Nursing, Korea University, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Setor K","family":"Kunutsor","sequence":"additional","affiliation":[{"name":"National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK"},{"name":"Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Southmead Hospital, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jussi","family":"Kauhanen","sequence":"additional","affiliation":[{"name":"Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jari A","family":"Laukkanen","sequence":"additional","affiliation":[{"name":"Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland"},{"name":"Faculty of Sport and Health Science, University of Jyv\u00e4skyl\u00e4, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,2,3]]},"reference":[{"key":"2021070804575331800_zwaa228-B1","doi-asserted-by":"crossref","first-page":"2468","DOI":"10.1056\/NEJMsa0707519","article-title":"European Union Working Group on Socioeconomic Inequalities in Health. Socioeconomic inequalities in health in 22 European countries","volume":"358","author":"Mackenbach","year":"2008","journal-title":"N Engl J Med"},{"key":"2021070804575331800_zwaa228-B2","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1177\/2047487318787333","article-title":"A hospital-based study of socioeconomic status and clinical spectrum of rheumatic heart disease patients of Assam, north-east India","volume":"25","author":"Baro","year":"2018","journal-title":"Eur J Prev Cardiol"},{"key":"2021070804575331800_zwaa228-B3","doi-asserted-by":"crossref","first-page":"2166","DOI":"10.1161\/CIRCULATIONAHA.117.029652","article-title":"Socioeconomic status and cardiovascular outcomes: Challenges and interventions","volume":"137","author":"Schultz","year":"2018","journal-title":"Circulation"},{"key":"2021070804575331800_zwaa228-B4","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/j.pcad.2018.11.005","article-title":"An update on the role of cardiorespiratory fitness, structured exercise and lifestyle physical activity in preventing cardiovascular disease and health risk","volume":"61","author":"Ozemek","year":"2018","journal-title":"Prog Cardiovasc Dis"},{"key":"2021070804575331800_zwaa228-B5","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.pcad.2019.01.002","article-title":"Cardiorespiratory fitness and cardiovascular disease \u2013 the past, present, and future","volume":"62","author":"Kaminsky","year":"2019","journal-title":"Prog Cardiovasc Dis"},{"key":"2021070804575331800_zwaa228-B6","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1161\/CIRCRESAHA.118.312669","article-title":"Sedentary behavior, exercise, and cardiovascular health","volume":"124","author":"Lavie","year":"2019","journal-title":"Circ Res"},{"key":"2021070804575331800_zwaa228-B7","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.mayocp.2016.09.013","article-title":"Cardiorespiratory fitness and incidence of major adverse cardiovascular events in US veterans: A cohort study","volume":"92","author":"Kokkinos","year":"2017","journal-title":"Mayo Clin Proc"},{"key":"2021070804575331800_zwaa228-B8","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.164.10.1092","article-title":"Cardiorespiratory fitness attenuates the effects of the metabolic syndrome on all-cause and cardiovascular disease mortality in men","volume":"164","author":"Katzmarzyk","year":"2004","journal-title":"Arch Intern Med"},{"key":"2021070804575331800_zwaa228-B9","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1016\/j.amjmed.2017.04.042","article-title":"Cardiorespiratory fitness and incidence of type 2 diabetes in United States veterans on statin therapy","volume":"130","author":"Kokkinos","year":"2017","journal-title":"Am J Med"},{"key":"2021070804575331800_zwaa228-B10","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1177\/2047487318793459","article-title":"Physical fitness is a modifiable predictor of early cardiovascular death: A 35-year follow-up study of 2014 healthy middle-aged men","volume":"25","author":"Engeseth","year":"2018","journal-title":"Eur J Prev Cardiol"},{"key":"2021070804575331800_zwaa228-B11","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s40798-018-0137-0","article-title":"Socioeconomic correlates and determinants of cardiorespiratory fitness in the general adult population: A systematic review and meta-analysis","volume":"4","author":"Ombrellaro","year":"2018","journal-title":"Sports Med Open"},{"key":"2021070804575331800_zwaa228-B12","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1093\/aje\/kwj357","article-title":"Socioeconomic and psychosocial exposures across the life course and binge drinking in adulthood: Population-based study","volume":"165","author":"Yang","year":"2007","journal-title":"Am J Epidemiol"},{"key":"2021070804575331800_zwaa228-B13","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/S0140-6736(94)91468-0","article-title":"Childhood and adult socioeconomic status as predictors of mortality in Finland","volume":"343","author":"Lynch","year":"1994","journal-title":"Lancet"},{"key":"2021070804575331800_zwaa228-B14","doi-asserted-by":"crossref","first-page":"1476","DOI":"10.1016\/j.jacc.2010.05.043","article-title":"Cardiorespiratory fitness is related to the risk of sudden cardiac death: A population-based follow-up study","volume":"56","author":"Laukkanen","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"2021070804575331800_zwaa228-B15","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.mayocp.2017.10.011","article-title":"Cardiorespiratory fitness and health outcomes: A call to standardize fitness categories","volume":"93","author":"Kokkinos","year":"2018","journal-title":"Mayo Clin Proc"},{"key":"2021070804575331800_zwaa228-B16","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1002\/ejhf.1433","article-title":"Cardiorespiratory fitness, body mass index and heart failure incidence","volume":"21","author":"Kokkinos","year":"2019","journal-title":"Eur J Heart Fail"},{"key":"2021070804575331800_zwaa228-B17","doi-asserted-by":"crossref","first-page":"e65130","DOI":"10.1371\/journal.pone.0065130","article-title":"Socioeconomic status, functional recovery, and long-term mortality among patients surviving acute myocardial infarction","volume":"8","author":"Alter","year":"2014","journal-title":"PLoS One"},{"key":"2021070804575331800_zwaa228-B18","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1001\/jama.295.7.784","article-title":"Association of socioeconomic status with functional capacity, heart rate recovery, and all-cause mortality","volume":"295","author":"Shishehbor","year":"2006","journal-title":"JAMA"},{"key":"2021070804575331800_zwaa228-B19","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1016\/j.amjcard.2007.09.093","article-title":"Association of socioeconomic status and exercise capacity in adults with coronary heart disease (from the Heart and Soul Study)","volume":"101","author":"Cohen","year":"2008","journal-title":"Am J Cardiol"},{"key":"2021070804575331800_zwaa228-B20","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/j.ahj.2007.07.055","article-title":"Association of neighborhood socioeconomic status with physical fitness in healthy young adults: The Coronary Artery Risk Development in Young Adults (CARDIA) study","volume":"155","author":"Shishehbor","year":"2008","journal-title":"Am Heart J"},{"key":"2021070804575331800_zwaa228-B21","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1186\/1475-9276-11-78","article-title":"Longitudinal changes in functional capacity: Effects of socio-economic position among ageing adults","volume":"11","author":"Sulander","year":"2012","journal-title":"Int J Equity Health"},{"key":"2021070804575331800_zwaa228-B22","doi-asserted-by":"crossref","first-page":"2024","DOI":"10.1001\/jama.2009.681","article-title":"Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: A meta-analysis","volume":"301","author":"Kodama","year":"2009","journal-title":"JAMA"},{"key":"2021070804575331800_zwaa228-B23","doi-asserted-by":"crossref","first-page":"l4570","DOI":"10.1136\/bmj.l4570","article-title":"Dose\u2013response associations between accelerometry measured physical activity and sedentary time and all cause mortality: Systematic review and harmonised meta-analysis","volume":"366","author":"Ekelund","year":"2019","journal-title":"BMJ"},{"key":"2021070804575331800_zwaa228-B24","doi-asserted-by":"crossref","first-page":"E17","DOI":"10.5888\/pcd12.140392","article-title":"Associations between family income and children\u2019s physical fitness and obesity in California, 2010\u20132012","volume":"12","author":"Jin","year":"2015","journal-title":"Prev Chronic Dis"},{"key":"2021070804575331800_zwaa228-B25","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1056\/NEJMoa011858","article-title":"Exercise capacity and mortality among men referred for exercise testing","volume":"346","author":"Myers","year":"2002","journal-title":"N Engl J Med"},{"key":"2021070804575331800_zwaa228-B26","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1161\/CIRCOUTCOMES.113.000531","article-title":"Prediction of 30-year risk for cardiovascular mortality by fitness and risk factor levels: The Cooper Center Longitudinal Study","volume":"7","author":"Wickramasinghe","year":"2014","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"2021070804575331800_zwaa228-B27","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1016\/j.amjcard.2016.07.064","article-title":"Relation of cardiorespiratory fitness to risk of subclinical atherosclerosis in men with cardiometabolic syndrome","volume":"118","author":"Jae","year":"2016","journal-title":"Am J Cardiol"},{"key":"2021070804575331800_zwaa228-B28","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.diabres.2010.08.025","article-title":"Association between cardiorespiratory fitness and arterial stiffness in men with the metabolic syndrome","volume":"90","author":"Jae","year":"2010","journal-title":"Diabetes Res Clin Pract"},{"key":"2021070804575331800_zwaa228-B29","doi-asserted-by":"crossref","first-page":"e002262","DOI":"10.1161\/CIRCIMAGING.114.002262","article-title":"Comparison of coronary artery calcium presence, carotid plaque presence, and carotid intima-media thickness for cardiovascular disease prediction in the Multi-Ethnic Study of Atherosclerosis","volume":"8","author":"Gepner","year":"2015","journal-title":"Circ Cardiovasc Imaging"},{"key":"2021070804575331800_zwaa228-B30","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/j.jacc.2019.05.042","article-title":"Does socioeconomic status influence the risk of subclinical atherosclerosis?: A mediation model","volume":"74","author":"Redondo-Bravo","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2021070804575331800_zwaa228-B31","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.pcad.2018.12.003","article-title":"The association between the change in directly measured cardiorespiratory fitness across time and mortality risk","volume":"62","author":"Imboden","year":"2019","journal-title":"Prog Cardiovasc Dis"},{"key":"2021070804575331800_zwaa228-B32","doi-asserted-by":"crossref","first-page":"e653","DOI":"10.1161\/CIR.0000000000000461","article-title":"Importance of assessing cardiorespiratory fitness in clinical practice: A case for fitness as a clinical vital sign: A scientific statement from the American Heart Association","volume":"134","author":"Ross","year":"2016","journal-title":"Circulation"}],"container-title":["European Journal of Preventive Cardiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2047487319901057","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2047487319901057","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/academic.oup.com\/eurjpc\/article-pdf\/28\/4\/450\/37900315\/zwaa228.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/eurjpc\/article-pdf\/28\/4\/450\/37900315\/zwaa228.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T08:59:14Z","timestamp":1625734754000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjpc\/article\/28\/4\/450\/6272718"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,3]]},"references-count":32,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,2,3]]},"published-print":{"date-parts":[[2021,5,8]]}},"URL":"https:\/\/doi.org\/10.1177\/2047487319901057","relation":{},"ISSN":["2047-4873","2047-4881"],"issn-type":[{"value":"2047-4873","type":"print"},{"value":"2047-4881","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,4,1]]},"published":{"date-parts":[[2020,2,3]]}}}