The association of non-exercise estimated cardiorespiratory fitness with hypertension and all-cause mortality in American and Chinese populations: evidence from NHANES and CHARLS

Background 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. Methods 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 all-cause mortality. NEE-CRF was calculated using a sex-specific longitudinal non-exercise 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 all-cause 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. Conclusions Higher NEE-CRF levels may reduce the risk of developing hypertension and all-cause mortality.