June 28, 2022 Editorials

Further evidence that cardiorespiratory fitness is a vital sign!

Cardiovascular disease (CVD) as well as cancer are two major causes of mortality worldwide. Despite the pharmacotherapies and increasingly specialized techniques available to the medical community to manage these chronic diseases, it is also important to intervene upstream in order to prevent their development. Adopting a healthy and active lifestyle, which benefits in the prevention of chronic diseases are well documented, is an excellent way to achieve this. Moreover, regular endurance exercise is associated with a favorable level of cardiorespiratory fitness (CRF) which, in turn, is predictive of longevity.

In this regard, a recent meta-analysis has investigated the relationship between CRF and all-cause, CVD, and cancer mortality. A total of 34 studies were included in the meta-analyses (24 for all-cause mortality, 18 for CVD mortality, and 13 for cancer mortality). With each one-MET increase in CRF, the risk of all-cause mortality was reduced by 12%, the risk of CVD mortality by 13% and the risk of cancer mortality by 7%. An additional analysis was performed where individuals were classified according to their CRF levels (lowest, intermediate and highest CRF subgroups). As compared to individuals with the lowest CRF levels, those in the highest subgroup had a reduced risk of all-cause mortality of 53%. Lower CVD mortality (51%) and cancer mortality (43%) were observed when subjects with the highest CRF levels were compared to those with the lowest levels.      

Results from this meta-analysis further emphasize the importance of measuring and targeting CRF to improve the prediction of all-cause, CVD, and cancer mortality. CRF must now be considered as a vital sign on the same basis as traditional risk factors such as blood pressure or cholesterol levels.