High Cardiorespiratory Fitness Associated with Reduced Risk of Mortality and Chronic Disease Incidence

by | Jun 12, 2024 | 2024, Cardiovascular Health, Fitness and Exercise, Recent Articles

Written by Chrystal Moulton, Science Writer. This analysis of systemic reviews showed that cardiorespiratory fitness could be a strong predictor of mortality and chronic incident risk in adults.

heart healthCardiorespiratory fitness (CRF) is a trait reflecting the delivery and use of oxygen to support physical activity1. This trait can be measured directly through exercise testing and indirectly through predictive equations2,3. Cardiorespiratory fitness (CRF) is affected by both genetics and physical activity4. Previous studies have shown that low cardiorespiratory fitness (CRF) is attributed to chronic disease and thus, should be included in patient management5. In the current study, researchers investigated the relationship between cardiorespiratory fitness (CRF) and health outcomes in adults by examining systemic reviews including meta-analysis from cohort studies6.

Researchers conducted a literary search of systemic reviews with meta-analysis that pulled data from prospective and retrospective cohort studies or case control studies. Only systemic reviews published in English, French, or Spanish in peer reviewed journals during the past 20 years were eligible. All health-related outcomes were included with a primary focus on all-cause and cause specific mortality. Researchers graded studies that were included in this analysis based on imprecision, risk of bias, publication bias, inconsistency, and indirectness. Observational studies were graded as high in this analysis because randomized controlled trials were not feasible for this particular investigation. Researchers also downgraded studies with unbalanced gender samples and lack of global representation. Results were presented as pooled hazard ratios or relative risks for a specific incident (morbidity or mortality). Researchers made sure to identify systemic reviews that did not have overlapping primary studies in each of them.

Investigators initially identified 9062 systemic reviews. After examining the evidence, only 26 systemic reviews were included in this analysis. Using the data from these 26 studies, researchers calculated the risk of all-cause mortality, CVD mortality, sudden cardiac mortality, and other incidents among adults with high versus low cardiorespiratory fitness (CRF). Comparing high versus low CRF, researchers observed a 41-53% reduced risk of premature mortality. Also, 1 metabolic equivalents of task [common measure of peak oxygen intake/kg of body mass] increase in CRF was associated with 7-51% reduction in premature mortality. Furthermore, higher CRF was associated with a 37- 69% reduced risk of chronic conditions in men. In individuals living with chronic conditions, higher CRF was associated with a 19-37% reduction in all-cause mortality, CVD mortality, and heart failure mortality. The grade or certainty of the evidence across each result was rated as very low to moderate because of lack of indirectness since the population were mostly male.

This analysis of systemic reviews showed that cardiorespiratory fitness could be a strong predictor of mortality and chronic incident risk in adults. Additional analyses that include a larger female population would be needed to verify the generalizability of this trait as an indicator of mortality and chronic incident risk in adults.

Source: Lang, Justin J., Stephanie A. Prince, Katherine Merucci, Cristina Cadenas-Sanchez, Jean-Philippe Chaput, Brooklyn J. Fraser, Taru Manyanga et al. “Cardiorespiratory fitness is a strong and consistent predictor of morbidity and mortality among adults: an overview of meta-analyses representing over 20.9 million observations from 199 unique cohort studies.” British journal of sports medicine 58, no. 10 (2024): 556-566.

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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Posted June 11, 2024.

Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.

References:

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  6. Lang JJ, Prince SA, Merucci K, et al. Cardiorespiratory fitness is a strong and consistent predictor of morbidity and mortality among adults: an overview of meta-analyses representing over 20.9 million observations from 199 unique cohort studies. Br J Sports Med. May 2 2024;58(10):556-566. doi:10.1136/bjsports-2023-107849