Aim. The major aim of the study was to determine the association of high density lipoprotein (HDL) cholesterol and plasma Fibrinogen in determining the risk of mortality due to CVD. The secondary aim of the study was to examine the effect of cardio-respiratory fitness (CRF) on this relationship.

Methods. This is a cohort of predominantly Caucasian men and women of higher socio-economic status (N=25673) who visited the Cooper Clinic in or after 1990 and are a part of the Aerobic Center Longitudinal Study (ACLS). The main predictor variables were collected at single point in time. The death registry was used for the follow-up of the outcome - mortality due to CVD. Survival analysis technique was used to assess the association between the predictors and the outcome.

Results. HDL was associated with CVD death (HR 0.985 [0.97–1.00]) but the association was only marginally significant p=0.054. The association between fibrinogen and CVD death was significant: HR 1.004 (1.001–1.007).With the addition of CRF, HDL had a protective effect (HR 0.989) on CVD death which was not statistically significant (CI 0.974–1.004) p=0.155 and Fibrinogen had an association with CVD death (HR 1.003), which was also not statistically significant (CI 0.999–1.004) p=0.101. CRF has a significant protective relationship with CVD death: HR 0.924 (CI 0.89–0.971).

Conclusion. This study concludes that fibrinogen plays a role in predicting death due to CVD in this adult Caucasian population of higher SES while HDL has a weak association in predicting the mortality due to CVD. Cardio-respiratory fitness provides a protective effect on death due to CVD. CRF may play a role mediating the fibrinogen-CVD death relationship.