Heart disease risk: Poor exercise tolerance carries more weight than pounds

Related articles

A new Mayo Clinic study suggests that when assessing heart disease risk, looks can be deceiving. Reporting in the American Heart Journal, Dr. Francisco Lopez-Jiminez and his colleagues conclude that patients who have suffered a heart attack or angina (chest pain associated with heart problems) and are of normal weight but less physically fit are more likely to die from coronary heart disease than their heavier but more fit peers.

Researchers recruited 855 men and women already enrolled in a cardiac rehabilitation program to assess their fitness levels by determining how how far they could walk on a treadmill and the amount of oxygen the exercise consumed. They were categorized as overweight or obese based on their BMI measurements. Compared to thin-and-fit patients, who served as a control group, fit-but-overweight patients were twice as likely to die from heart failure while their fit-but-obese counterparts were three-times as likely. Meanwhile, out-of-shape but normal-weight subjects were ten times more likely to die but those who were heavier and unfit were at seven times higher risk than the control group.

ACSH’s Dr. Elizabeth Whelan concludes that whether you’re obese, overweight or normal weight, you’re better off being fit. “Being thin does not protect you from the threat of heart disease, and for those who are overweight or obese, regular exercise will increase fitness and cut the pounds.”

ACSH's Dr. Gilbert Ross adds, however, that this study is not a randomized controlled study, thus its conclusions are shaky. “The study fails to take cholesterol- or blood pressure-lowering medications into account. Exercise, however, is a healthful behavior that everyone should take up, after discussion with their doctor.”