Cardiorespiratory fitness

Declines with age in men and women.

Body composition and physical activity are related to CRF.

CRF is correlated with measures of lung, cardiovascular, skeletal muscle, and metabolic function, and insufficiencies in one or more systems involved in delivering atmospheric oxygen to the mitochondria and/or removal of metabolic byproducts from the body reduces CRF.

An index of habitual physical activity, that integrates human body function under the demanding physiological stress and reflects an individual’s functional capacity.

An important measure of human health that represents both cumulate physical activity and underlying genetic composition.


CRF is an attribute, rather than a behavior, and includes a significant genetic component.

CRF is largely developed by physical activity patterns.

Should be considered a clinical vital sign.

Consistently is associated with normal weight and lower risk of premature morbidity and mortality.

A physiological measure of the bodies ability to transport and utilize oxygen to perform physical work, and it is a strong predictor of mortality, independent of risk factors such as smoking, diabetes, and hypertension.

An indicator of total body health.

The association of CRF and health is stronger than the effective physical activity on health: direct measures of CRF are more precise than assessment of physical activity, physical activity is often assessed over short periods of time, whereas CRF is considered an enduring trait influenced by chronic habituation of physical activity.

CRF is independent of physical activity and is influenced by genetics and sub clinical disease.

Higher CRF is associated with lower risk of cardiovascular disease, metabolic syndrome, risk factors for Alzheimer’s disease, and vascular dementia, diabetes mellitus, hypertension, obesity, depression, smoking, and low education level.

Estimated CRF is inversely associated with mortality risk.

An exercise estimated CRF (eCRF) algorithm includes assessment of age, body mass index, waist circumference, resting heart rate, physical activity, and smoking status.

Using an estimated CRF it was found over a mean study of 19.5 years of follow up that for every 3.5 mL per kilogram/min increase in estimated oxygen consumption, there was a 30% and 27% risk reduction for all-cancer mortality mortality in men and women, respectively.

It is inversely associated with depression severity and cancer mortality.

Increasing physical activity is the major pathway by which CRF can be enhanced.


Eliminating low CRF and inactivity alone would reduce mortality by >20%.


About half of variation in CRF is heritable.


Aerobic exercise may be useful in slowing cognitive changes in aging.


Exercise may be useful in slowing clinical progression from mild cognitive impairment to dementia.


A study from Norway evaluated participants’ CRF at two points in time to evaluate if changes in physical fitness would have an impact on cognitive outcomes and mortality: It was estimated that participants who increased their estimated CRF over time gained 2.2 dementia-free years, and 2.7 years of life when compared with those who remained unfit at the two assessments.


There is a lack of association between CRF and white matter as opposed to gray matter with CRF.


Swedish military conscript study found


low fitness at age 18 years is associated with early-onset dementia.


It reflects an individual‘s ability to transport oxygen from the atmosphere to mitochondria in body cells, which requires collaboration of the lungs, heart, blood vessels, and organs receiving oxygen.

The protective effects of CRF on mortality is iys modulation in cardiac metabolic risk factors such as blood pressure, lipid, glucose levels, natriuretic peptide level, cardiac troponin T level, anti-inflammatory effects, improvement in endothelial function, regulation of cardiac autonomic function, and increase in cardiac output, left ventricular function, oxygen utilization, and the formation of collateral vessels

Should be assessed in clinical practice to optimize the prevention and treatment of cardiovascular disease.

CRF is associated with a decreased risk for heart failure.

A modifiable factors associated with cardiovascular disease, can be defined as the ability of the circulatory, respiratory, and muscular systems to supply oxygen during sustained physical activity.

CRF levels are generally higher in men.

Age related longitudinal decline is not linear (Baltimore Longitudinal Study of Aging).

Men are reportedly more physically active than women.

CRF is a much more powerful predictor of CV risk than is physical activity.

There is a strong inverse relationship between cardiorespiratory fitness and health care costs.

Poor cardiorespiratory fitness is associated with elevated markers of insulin resistance in healthy non-diabetic adults, independent of weight.
Fitness reduces the risk for insulin resistance and may be most beneficial among obese  individuals.

At an average age of 60 years individuals will self reported high compared with low physical fitness lived on average five years longer (Moore SC).

Men and women reporting a brisk walking pace have a life expectancy of more than 86 and 85 years, respectively. (Zaccardi F).

Women and men with low BMI and slow walking pace have a life expectancy estimated at 72 and 65 years, respectively.

Individuals reporting brisk walking pace have longer life expectancy regardless of their adiposity category compared with slow walkers, shorter life expectancies are particularly pronounced as the lower lowest levels of adiposity.

Cardio respiratory fitness is positively associated with gray matter volume, total brain volume, and specific gray matter and white matter clusters in brain areas not primarily involved in movement.

Cardiorespiratory fitness may contribute to brain health and may decelerate gray matter decrease.

Cardiorespiratory fitness associated with higher white matter volumes, fewer white matter lesions, and improved white matter microstructure in relation to higher physical fitness.

Cardio respiratory fitness is protective of atrial fibrillation, which is the most common arrhythmia worldwide with clinical significance.

CRF significantly modulates cardiovascular disease risk associated with dyslipidemia.

Accumulating 7-14 miles per week of moderate intensity exercise, such as running, can lower the risk associated with increased triglyceride:HDL-C levels.

Peak Vo2 is preferred CRF measurement.

Peak oxygen consumption per unit of time (Vo2) decreases by 3% to 6% per decade for the third and fourth decades of life, and after 70 years of age the rateof decline increases to more than 20% per decade (Fleg).

Directly measured maximal oxygen uptake (V02) is an objective and quantitative measure of cardio respiratory fitness and is the gold standard for assessing the amount of oxygen consumption during exercise.

Cardiorespiratory fitness expressed as a whole-body resting oxygen consumption of 3.5 mL/kg per min.

CRF can be directly measured as maximal oxygen consumption (Vo2max) from a cardiopulmonary exercise testing or estimated as the exercise capacity, that is, maximal work rate from an exercise test.

Accelerated rate of decline in CRF is not affected by variation in physical activity, but at all ages the more active patients are more fit.

Quantifies the ability of the body to transport and use oxygen at the working muscle.

High CRF during childhood and adolescence is associated with a healthier cardiovascular profile during these years, and also later in life.

Low levels of cardiorespiratory fitness may be one of the strongest risks factors for cardiovascular disease.

Increasing cardiorespiratory fitness provides the lowest risk of hypertension in middle-aged relatively healthy population.

Individual CRF levels is a stronger predictive mortality than traditional risk factors including smoking, hyper tension, hyperlipidemia, type two diabetes, and other exercise variables such as ST segment depression and hemodynamic responses.

Low levels of cardiorespiratory fitness is a strong predictor of all-cause and cardiovascular mortality in healthy individuals.

Increases in BMI and reduction in cardiorespiratory fitness overtime predicts a higher mortality.

Higher levels of CRF are accompanied by a lower risk of cardiovascular disease outcomes, regardless of levels of BMI.

Runners typically perform vigorous physical activity and have high levels of cardiorespiratory fitness.

Running, even in low doses, is associated with substantial reductions in cardiovascular and all-cause mortality.

Regular exercise training can increase CRF and is part of all medical therapy for the treatment of coronary artery disease.

Directly associated with BMD.

CRF can attenuate or even potentially eliminate the harmful effects of obesity.

Men are reportedly more physically active than women.

Maximal oxygen uptake, a measure of fitness, is higher in men versus women

Men demonstrates a 1.7 METs higher than women, but their survival is equivalent to that of women demonstrating 2.6 METs lower.

High levels of running have the potential for cardiotoxicity.

Maximum health benefits of running occur at low doses, well below those suggested by the US physical activity guidelines.

Associated with risk of morbidity, mortality, quality of life, reservation of function and maintenance of independence.

CRF has a strong protective effect against cardiovascular disease and is inversely related to obesity and metabolic risk factors.

CRF is a more powerful predictor of risk for adverse health outcomes than traditional risk factors, including hypertension, lipid abnormalities, smoking abuse, physical inactivity, obesity, and diabetes.

Increasing exercise intensity is a very strong determinant of CRF across individuals.

High fitness levels attenuate the risk of mortality in patients with high body mass index or adiposity.

Cardiorespiratory fitness as estimated by exercise capacity attenuates the progression of chronic diseases.

Low CRF indicating the lowest quartile or quintile on an exercise test is associated with a 2-5 fold increase cardiovascular disease or all cause mortality.

Cardiorespiratory fitness is inversely and independently associated with lower mortality risk regardless of age, sex, race, and documented cardiovascular disease, or other

Relatively small improvements in CRF, such as one metabolic equivalent, is associated with reductions in mortality of 10-25%.

Increase cardiorespiratory fitness and higher exercise capacity is associated with lower risk of all cause mortality and downstream revascularization in all patients with coronary artery disease and lower risk of MI in patients with previous PCI for coronary bypass graft surgery.

Higher exercise capacity attenuates the risk of developing chronic kidney disease.

Individuals with low CRF more likely to develop hypertension, diabetes, metabolic syndrome,cancer, death due to cardiovascular disease and death from all causes.

CRF provides incremental prognostic value in risk prediction on top of age, sex, systolic blood pressure, cholesterol level, and smoking status with your establish components of conventional cardiovascular risk scores.

There is an inverse, independent, and graded Association of CRF with all-cause mortality events.

CRF is inversely correlated with all-cancer and cancer-specific mortality, including breast cancer, digestive cancer, and lung cancer and cancer incidence.

Cardiorespiratory fitness is inversely related to all cause and cardiovascular mortality.

Cardiorespiratory fitness is inversely related to all cause and cardiovascular mortality in normal subjects and those with cardiovascular disease, and those with diabetes.

Low-level physical activity is associated with increased type II diabetes, and the metabolic syndrome.

Each 1-MET increments in exercise capacity is associated with approximately 13% reduction in risk of all-cause mortality irrespective of revascularization status in patients with coronary artery disease (Hung RK et al).

Every one MET improvement in cardiorespiratory fitness overtime is associated with the 7%, 22%, and 12% lower risk of hypertension, metabolic syndrome, and hypercholesterolemia, respectively.

CRF prevents the trajectory of increased blood pressure that occurs with aging.

Vo2max of 18 mL/kg or less associated with disability and used a measure of threshold value for independent living.

In a review of 3429 women and 16,889 men aged 20-96 years from the Aerobics Center Longitudinal Study found CRF declines at a nonlinear rate the accelerates after 45 years of age.

Keeping a low BMI, remaining physically active and not smoking associated with a higher CRF across adulthood life span (Jackson AS).

In a 10 year longitudinal study a mean longitudinal yearly change in Vo2 max of -0.19 mL/kg per minute for women and -0.43mL/kg per minute for men (Stathokostas).

A one-unit metabolic equivalent of task (MET) increase in baseline cardiorespiratory fitness resulted in an 18% decrease in cardiovascular mortality in FRS classified low risk adults over 30 year follow up.

Among men with emotional diseases a higher CRF is associated with lower risk of dying, underscoring the importance of providing physical activity for individuals with emotional disease.


Having low CRF  of <5.0 metabolic equivalents [METs] is associated with an approximate 3-fold higher risk of mortality.

Each higher MET achieved on the treadmill is associated with a 15% reduction in mortality.

Inactive subjects had a 23% higher mortality risk.

The least fit quartile of <5.0 METs had relative risks of ≈6.0 compared with the most-fit group.

The least-active tertile had ≈2-fold higher risks of mortality vs the most active subjects.

Both higher CRF and physical activity provide protection against all-cause mortality.

Participation in regular physical activity and higher cardiorespiratory fitness (CRF) reduce premature mortality and the incidence of numerous chronic conditions.

Current physical-activity guidelines recommend that adults participate in at least 150 minutes of moderate-intensity aerobic physical activity weekly to achieve significant health benefits. 

Among individuals who achieve these minimal levels of physical activity, risk of mortality has been demonstrated to be reduced by 20% to 50%, relative to inactive persons.

United States Health and Human Services (HHS) Guidelines on Physical Activity indicate that the vast majority, approximately 80%, of adults do not meet the minimal recommendations for activity. 

Higher prevalence of physical inactivity has contributed to a decline in CRF in recent years.

Low CRF has been demonstrated to be a more powerful predictor of risk for cardiovascular and all-cause mortality than traditional risk factors, including hypertension, smoking, and hyperlipidemia.

Physical activity patterns have been suggested to be at their lowest level in human history, with particularly marked declines in recent generations, and future projections suggest further declines globally.

WHO and Centers for Disease Control have estimated that physical inactivity accounts for approximately 8% to 9% of premature mortality.

Eliminating low CRF and inactivity alone would reduce mortality by >20%.

CRF is largely developed by physical activity patterns.

A significant proportion of the burden of cardiovascular disease and all-cause mortality would be eliminated by the adoption of several modifiable lifestyle changes, leading to an improvement in CRF.


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