A woman’s physical fitness level appears to tell a lot more about her cardiovascular disease risk than her weight or body mass index (BMI), according to a study reported in the September 8 issue of the Journal of the American Medical Association.

The study of 906 women found that those reporting higher levels of physical fitness have fewer coronary artery disease risk factors, less coronary artery disease and a lower risk for cardiovascular events, whereas measures of obesity are not as strongly associated with these outcomes.

Women with lower levels of physical fitness were more likely to have coronary artery disease risk factors and obstructive coronary artery disease than their counterparts with higher fitness levels (44 percent vs. 26 percent). Each 1-MET (measure of energy expenditure) increase in the women’s physical fitness level scores was independently associated with an 8 percent decrease in risk of major adverse cardiovascular events during the almost four-year follow-up period.

“Overweight women were more likely than normal weight women to have coronary artery disease risk factors, but neither BMI nor abdominal obesity measures were significantly associated with obstructive coronary artery disease or adverse cardiovascular events after adjusting for other risk factors," the authors write.

"These results suggest that fitness may be more important than overweight or obesity for cardiovascular risk in women,” concluded the researchers. “Evaluation of physical activity and functional capacity using simple questionnaires should be an integral part of cardiovascular risk stratification, and interventions aimed at increasing physical fitness levels should be included in the management of all women at risk for coronary heart disease.”

Other sources: Journal of the American Medical Association