Hansen GM, et al. - Given that the risk of chronic obstructive pulmonary disease (COPD) may be attenuated by good midlife cardiorespiratory fitness (CRF), and reverse causation may play a role if follow-up time is short, researchers examined employed men to assess the link between CRF and both incident COPD and COPD mortality, with a follow-up of 46 years, to account for reverse causality. As far as incident COPD was concerned, the estimated risk was 21% lower in participants with normal CRF and 31 % lower with high CRF, as compared with low CRF. In the magnitude of 1.3–1.8 years, a delay to incident COPD and death from COPD was demonstrated by restricted mean survival times in normal and high CRF, compared with low CRF. The results remained unaltered by test for reverse causation. Overall, a lower long-term risk of incident COPD and death from COPD was reported in relation to higher levels of CRF in this study sample of healthy, middle-aged men.