Treadmill fitness improved ten-year death risk predictions
A model’s score for distinguishing higher from lower death risk rose from 0.662 using traditional risk factors alone to 0.682 after adding treadmill fitness.
Medicine and Science in Sports and Exercise
In an observational cohort study, researchers analysed 562,234 adults who underwent clinical treadmill exercise testing. They measured heart and lung fitness using the peak exercise intensity each person reached. They compared models predicting death from any cause over ten years, with and without fitness. Both included age, sex, high blood pressure, diabetes, abnormal blood fat levels and smoking.
Follow-up averaged 10.2 years. Adding fitness improved the models’ ability to distinguish death risk and classify people into risk categories. Fitness remained associated with mortality after accounting for traditional risk factors. Adjusted ten-year death risk was 32.9% among the least fit fifth, compared with 13.4% among those classified as fit.
Why it matters
Assessing death risk over ten years is relevant to lifespan. The authors recommended considering fitness in routine clinical risk assessment.
Caveats
The observational design cannot show that increasing fitness reduces mortality. Participants came from a clinical exercise-testing cohort, so the results may not apply to all adults.
The paper
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Cristina Cadenas-Sanchez, Andreas Pittaras,Cardiology Division · Department of Medicine
Medicine and Science in Sports and Exercise · 6 Oct 2026
