A1 Journal article (refereed)
Physical fitness in male adolescents and atherosclerosis in middle age : a population-based cohort study (2024)

Herraiz-Adillo, Á., Ahlqvist, V. H., Higueras-Fresnillo, S., Hedman, K., Hagström, E., Fortuin-de Smidt, M., Daka, B., Lenander, C., Berglind, D., Östgren, C. J., Rådholm, K., Ortega, F. B., & Henriksson, P. (2024). Physical fitness in male adolescents and atherosclerosis in middle age : a population-based cohort study. British Journal of Sports Medicine, Early online, Article 107663. https://doi.org/10.1136/bjsports-2023-107663

JYU authors or editors

Publication details

All authors or editorsHerraiz-Adillo, Ángel; Ahlqvist, Viktor H; Higueras-Fresnillo, Sara; Hedman, Kristofer; Hagström, Emil; Fortuin-de Smidt, Melony; Daka, Bledar; Lenander, Cecilia; Berglind, Daniel; Östgren, Carl Johan; et al.

Journal or seriesBritish Journal of Sports Medicine



Publication year2024

Publication date14/02/2024

VolumeEarly online

Article number107663

PublisherBMJ Publishing Group

Publication countryUnited Kingdom

Publication languageEnglish


Publication open accessOpenly available

Publication channel open accessPartially open access channel

Publication is parallel published (JYX)https://jyx.jyu.fi/handle/123456789/93586


Objectives To examine the associations between physical fitness in male adolescents and coronary and carotid atherosclerosis in middle age.

Methods This population-based cohort study linked physical fitness data from the Swedish Military Conscription Register during adolescence to atherosclerosis data from the Swedish CArdioPulmonary bioImage Study in middle age. Cardiorespiratory fitness was assessed using a maximal cycle-ergometer test, and knee extension muscular strength was evaluated through an isometric dynamometer. Coronary atherosclerosis was evaluated via Coronary Computed Tomography Angiography (CCTA) stenosis and Coronary Artery Calcium (CAC) scores, while carotid plaques were evaluated by ultrasound. The associations were analysed using multinomial logistic regression, adjusted (marginal) prevalences and restricted cubic splines.

Results The analysis included 8986 male adolescents (mean age 18.3 years) with a mean follow-up of 38.2 years. Physical fitness showed a reversed J-shaped association with CCTA stenosis and CAC, but no consistent association was observed for carotid plaques. After adjustments, compared with adolescents in the lowest tertile of cardiorespiratory fitness and muscular strength, those in the highest tertile had 22% (OR 0.78; 95% CI 0.61 to 0.99) and 26% (OR 0.74; 95% CI 0.58 to 0.93) lower ORs for severe (≥50%) coronary stenosis, respectively. The highest physical fitness group (high cardiorespiratory fitness and muscular strength) had 33% (OR 0.67; 95% CI 0.52 to 0.87) lower OR for severe coronary stenosis compared with those with the lowest physical fitness.

Conclusion This study supports that a combination of high cardiorespiratory fitness and high muscular strength in adolescence is associated with lower coronary atherosclerosis, particularly severe coronary stenosis, almost 40 years later.

Keywordscardiovascular diseasesatherosclerosiscoronary diseaserisk factorsphysical fitnessmuscle strengthphysical trainingyoung adultscohort study

Contributing organizations

Ministry reportingYes

Reporting Year2024

Preliminary JUFO rating3

Last updated on 2024-15-06 at 21:26