There is substantial knowledge about the inverse association of physical fitness and CVD risk factors and CVD mortality. However, physical fitness per se might be influenced by lifestyle conditions such as physical training, smoking and drinking habits.

We evaluated the relationship between physical fitness, physical activity, endurance training, smoking and drinking habits and blood pressure, lipids and leukocytes as surrogate cardiovascular risk markers in a large-scale cross-sectional study of healthy young men.

A total of 6748 healthy young men were selected during their primary flight medical examination for military flying duties. Physical fitness was assessed by achieved physical working capacity at a heart rate of 170 beats per min (PWC₁₇₀) during cycle ergometry. Parameters such as physical activity, endurance sports, smoking of cigarettes and drinking of alcoholic beverages were assessed by means of standardized questionnaires. Systolic and diastolic blood pressures were measured manually. Fasting cholesterol and triglycerides as well as white blood counts were obtained.

Physical activity itself was not related to significant differences in the tested variables, whereas good physical fitness showed a significant association with improved blood pressure and blood lipids (P< 0.001) with no detectable threshold. This effect was independent of endurance training, smoking and drinking. Whereas drinking was associated with elevated systolic blood pressure, smoking was associated with markedly increased triglycerides as well as with elevated leukocytes.

Physical fitness is associated with improved blood pressure and blood lipids. This effect is independent of participating mainly in endurance or nonendurance sports, of physical activity per se, and it does not depend on smoking and drinking habits. Smoking itself revealed relevant higher inflammation independent of fitness.