Cardiorespiratory Fitness and Its Place in Medicine

¹ School of Kinesiology and Health Studies, Department of Medicine, Division of Endocrinology and Metabolism, Queen’s University, Kingston, Ontario K7P 3E8, Canada

² School of Medicine, VA Palo Alto Health Care System, Stanford University, Palo Alto, CA 94304, USA

^*Correspondence: rossr@queensu.ca (Robert Ross)
Academic Editor: Jerome L. Fleg

Rev. Cardiovasc. Med. 2023, 24(1), 14; https://doi.org/10.31083/j.rcm2401014

Submitted: 23 July 2022 | Revised: 12 October 2022 | Accepted: 19 October 2022 | Published: 6 January 2023

(This article belongs to the Special Issue Physical Activity and Fitness in the Prevention and Management of Cardiometabolic Disease)

This is an open access article under the CC BY 4.0 license.

Abstract

The evidence that cardiorespiratory fitness (CRF) predicts morbidity and mortality independent of commonly obtained risk factors is beyond dispute. Observations establishing that the addition of CRF to algorithms for estimating cardiovascular disease risk reinforces the clinical utility of CRF. Evidence suggesting that non-exercise estimations of CRF are associated with all-cause mortality provides an opportunity to obtain estimates of CRF in a cost-effective manner. Together with the observation that CRF is substantially improved in response to exercise consistent with guideline recommendations underscores the position that CRF should be included as a routine measure across all health care settings. Here we provide a brief overview of the evidence in support of this position.

Keywords

cardiorespiratory fitness

morbidity

mortality

physical activity

exercise

high intensity interval training

Figures

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Fig. 1.

Association between exercise dose and change in VO ${}_{2}$ peak over 24 weeks. Figure adapted from Ref. [10]. Values represent the observed change in VO ${}_{2}$ peak at 4, 8, 16 and 24 weeks in adults with a mean age of 53 years. VO ${}_{2}$ peak was not measured at weeks 4 and 8 within the control group. Values are least-squares estimated means adjusted for age and sex. HAHI, high amount high intensity; HALI, high amount low intensity; LALI, low amount low intensity (see Ref. [10] for details). At baseline, there were no differences between groups. At weeks 4, 8, 16, and 24, the increase in VO ${}_{2}$ peak was greater for the HAHI group than the LALI (p $<$ 0.001) and control (p $<$ 0.001) groups. At weeks 16 and 24, the increase in VO ${}_{2}$ peak was greater for the HALI group than the control (p $<$ 0.001) and LALI (p $<$ 0.001) groups. The increase in VO ${}_{2}$ peak for the HAHI group was greater than the HALI group at 8, 16, and 24 weeks (p = 0.03, 0.002, and 0.03, respectively).

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Rev. Cardiovasc. Med. Print ISSN 1530-6550 Electronic ISSN 2153-8174