Previous studies have demonstrated ethnic/racial differences in cardiorespiratory
fitness (CRF). However, the relative contributions of body mass index (BMI), lifestyle
behaviors, socioeconomic status (SES), cardiovascular (CV) risk factors, and cardiac
function to these differences in CRF are unclear. In this study, we included 2,617
Dallas Heart Study participants (58.6% women, 48.6% black; 15.7% Hispanic) without
CV disease who underwent estimation of CRF using a submaximal exercise test. We constructed
multivariable-adjusted linear regression models to determine the association between
race/ethnicity and CRF, which was defined as peak oxygen uptake (ml/kg/min). Black
participants had the lowest CRF (blacks: 26.3 ± 10.2; whites: 29.0 ± 9.8; Hispanics:
29.1 ± 10.0 ml/kg/min). In multivariate analysis, both black and Hispanic participants
had lower CRF after adjustment for age and gender (blacks: Std β = −0.15; p value
≤0.0001, Hispanics: Std β = −0.05, p value = 0.01; ref group: whites). However, this
association was considerably attenuated for black (Std β = −0.04, p value = 0.03)
and no longer significant for Hispanic ethnicity (p value = 0.56) after additional
adjustment for BMI, lifestyle factors, SES, and CV risk factors. Additional adjustment
for stroke volume did not substantially change the association between black race/ethnicity
and CRF (Std β = −0.06, p value = 0.01). In conclusion, BMI, lifestyle, SES, and traditional
risk factor burden are important determinants of ethnicity-based differences in CRF.
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Article Info
Publication History
Published online: May 28, 2016
Accepted:
May 23,
2016
Received in revised form:
May 23,
2016
Received:
February 17,
2016
Footnotes
Dr. Berry receives funding from the Dedman Family Scholar in Clinical Care endowment at University of Texas Southwestern Medical Center, Dallas, Texas and 14SFRN20740000 from the American Heart Association prevention network, Dallas, Texas.
The corresponding author had full access to all data in the study and had final responsibility for the decision to submit for publication. All authors have read and agreed to the manuscript as written.
See page 502 for disclosure information.
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Copyright
© 2016 Elsevier Inc. All rights reserved.
