(HealthDay News) — Poor physical fitness ranks right behind smoking as leading risk factors for early mortality, according to a study published online July 26 in the European Journal of Preventive Cardiology.

The new research analyzed 792 men born in 1913 who performed an exercise test in 1967, at 54 years of age. More than 650 of the healthiest men also had measurements of maximal oxygen uptake, VO2 max. Tracking the men and using information from several physical exams in intervening years, the researchers obtained data on deaths from all causes. To determine the association between predicted VO2 max and mortality, study participants were divided into three groups ranging from low to high VO2 max.

The researchers found that each increase in predicted VO2 max levels was linked with a 21 percent lower risk of death over 45 years of follow-up, even after adjusting for other risk factors such as smoking, blood pressure, and cholesterol levels.

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“Fitness in middle age is of importance for mortality risk for several decades,” study author Per Ladenvall, Ph.D., a researcher in the department of molecular and clinical medicine at the University of Gothenburg in Sweden, told HealthDay. “We were somewhat surprised that the effect of aerobic capacity was even more pronounced than that of high cholesterol and high blood pressure.”

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