The Association of Non-Exercise Estimated Cardiorespiratory Fitness with Hypertension and All-Cause Mortality in American and Chinese Populations: Evidence from NHANES and CHARLS

Tan, Moyao; Zhang, Ping; Zhu, Si-Xuan; Wu, Shan; Gao, Ming

doi:10.3389/fcvm.2025.1497292

ORIGINAL RESEARCH article

Front. Cardiovasc. Med.

Sec. Hypertension

Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1497292

This article is part of the Research Topic Exploring the Role of Exercise in Hypertension and Blood Pressure Variability View all 4 articles

The Association of Non-Exercise Estimated Cardiorespiratory Fitness with Hypertension and All-Cause Mortality in American and Chinese Populations: Evidence from NHANES and CHARLS

Provisionally accepted

Moyao Tan ¹

Ping Zhang ¹

Si-Xuan Zhu ² Shan Wu

Shan Wu ²

Ming Gao ^1*

¹ Chengdu Integrated TCM and Western Medical Hospital, Chengdu, China
² Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China

The final, formatted version of the article will be published soon.

The Non-Exercise Estimated Cardiorespiratory Fitness (NEE-CRF) method has gained attention in recent years due to its simplicity and effectiveness.Hypertension and all-cause mortality are significant public health issues worldwide, highlighting the importance of exploring the association between NEE-CRF and these two conditions.The data from the National Health and Nutrition Examination Survey (NHANES) and the China Health and Retirement Longitudinal Study (CHARLS) were utilized to validate the association between NEE-CRF and hypertension as well as allcause mortality. NEE-CRF was calculated using a sex-specific longitudinal nonexercise equation. To investigate the relationship between hypertension and all-cause mortality, multivariable regression analysis, generalized additive models, smooth curve fittings, and threshold effect analysis were employed. Logistic regression was used for hypertension analysis, while Cox proportional hazards regression was applied for allcause mortality. Additionally, we conducted stratified analyses and interaction tests among different groups.Results: In the NHANES, after fully adjusting for covariates, each unit increase in NEE-CRF was associated with a 24% reduction in the risk of hypertension (OR: 0.76, 95% CI: 0.74-0.78) and a 12% reduction in the risk of all-cause mortality (HR: 0.88, 95% CI: 0.79-0.86). Subgroup analyses showed that the relationship between NEE-CRF and both hypertension and all-cause mortality remained negatively correlated across different subgroups. The negative association was also validated in the CHARLS.Higher NEE-CRF levels may reduce the risk of developing hypertension and all-cause mortality.

Keywords: non-exercise estimated cardiorespiratory fitness, Hypertension, All-cause mortality, NHANES, CHARLS

Received: 16 Sep 2024; Accepted: 31 Mar 2025.

Copyright: © 2025 Tan, Zhang, Zhu, Wu and Gao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Ming Gao, Chengdu Integrated TCM and Western Medical Hospital, Chengdu, China

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