The New Scientific Statement from the American Heart Association (AHA) has just been published and it identifies cardiorespiratory fitness (CRF) as a vital sign, which should be used in clinical practice. Plethora of evidence points to CRF as a better predictor of adverse health outcomes than the traditionally utilized risk factors such as high blood pressure, smoking, obesity and type 2 diabetes. CRF is either directly measured as maximal oxygen uptake (VO2max) using cardiopulmonary exercise testing or it is estimated as exercise capacity from an exercise test.
Even very small improvements in CRF were found to associate with significant reductions in risk of developing heart disease and dying prematurely, improved cardiovascular outcomes, and improved outcomes for certain forms of cancer, surgical risk, dementia, Alzheimer’s disease, depression and Type 2 diabetes.
Yet, while low CRF is one of the most important factors when determining health outcomes, it is often neglected by clinicians in the risk assessment of patients.
“With the increase in lifestyle-related diseases around the world, estimated fitness is an easy, cost-effective method that could significantly help medical professionals identify people at high risk and improve patient management,” says co-author Carl J. Lavie, MD, and lead cardiologist from the John Ochsner Heart and Vascular Institute, New Orleans, US.
“Routine estimation of CRF in clinical practice is no more difficult than measuring blood pressure. The addition of CRF for risk classification presents health professionals with unique opportunities to improve patient management and encourage lifestyle-based strategies designed to reduce cardiovascular risk”, says Dr. Wisloff, Head of K.G. Jebsen Center of Exercise in Medicine at Norwegian University of Science and Technology, and the last author of the statement.
“The evidence reviewed by our writing group clearly demonstrates that more than half the reduction in cardiovascular disease mortality occurs in response to a very modest increase in CRF. This is good news as for many people, moderate levels of physical activity that increase fitness level may be all that is needed to derive a clinically significant benefit for habitually sedentary individuals,” says Dr. Ross of Queen’s University in Kingston, Canada and first author of the statement.
One of the calculators for estimating fitness that the AHA suggests should be used on a regular basis by both the medical professionals and the general public was created by the researchers at K.G. Jebsen Center for Exercise in Medicine at NTNU. The calculator has been used by more than 5 million people worldwide, with the number of users increasing daily. The fitness calculator is freely available online and as App for Android and iOS.
Ulrik Wisløff, head of CERG