Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign A Scientific Statement From the American Heart Association

@article{Ross2016ImportanceOA,
  title={Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign A Scientific Statement From the American Heart Association},
  author={Robert Ross and Steven N. Blair and Ross Arena and Timothy S. Church and Jean-Pierre Despr{\'e}s and Barry A. Franklin and William L. Haskell and Leonard A. Kaminsky and Benjamin D. Levine and Carl J. Lavie and Jonathan Myers and Josef Niebauer and Robert Sallis and Susumu S. Sawada and Xuemei Sui and Ulrik Wisl{\o}ff},
  journal={Circulation},
  year={2016},
  volume={134},
  pages={e653–e699}
}
Mounting evidence has firmly established that low levels of cardiorespiratory fitness (CRF) are associated with a high risk of cardiovascular disease, all-cause mortality, and mortality rates attributable to various cancers. A growing body of epidemiological and clinical evidence demonstrates not only that CRF is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, high cholesterol, and type 2 diabetes mellitus, but that the addition of CRF… 
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Clinical Perspectives on Incorporating Cardiorespiratory Fitness in Clinical Practice
TLDR
Support is provided for the diagnostic and prognostic use of CRF based on the current literature and a case is made for the use of CPX when available, as well as the need for standardization of normative values defining CRF levels to increase the efficacy of the risk assessment.
The role of cardiorespiratory fitness on the risk of sudden cardiac death at the population level: A systematic review and meta-analysis of the available evidence.
The Chester step test is a valid tool to assess cardiorespiratory fitness in adults with hypertension: reducing the gap between clinical practice and fitness assessments
TLDR
The validity of the CST to estimate the maximal oxygen uptake (VO2max) in adults with hypertension is tested and the influence of different formulas for predicting the age-predicted maximal heart rate (HRmax) when estimating the VO2max with the CST is assessed.
Association Between Cardiorespiratory Fitness and Healthcare Costs
  • J. Myers, P. Kokkinos
  • Medicine, Biology
    Cardiorespiratory Fitness in Cardiometabolic Diseases
  • 2019
TLDR
This chapter reviews the available literature addressing the association between CRF and healthcare costs and concludes that efforts to improve CRF not only have a favorable impact on health outcomes, but they also result in lower healthcare costs.
Cardiorespiratory Fitness, Coronary Artery Calcium, and Cardiovascular Disease Events in a Cohort of Generally Healthy Middle-Age Men: Results From the Cooper Center Longitudinal Study
TLDR
In a large cohort of generally healthy men, there is an attenuation of CVD risk at all CAC levels with higher CRF, and when CAC and CRF were considered together, there was a strong association between continuous CRF and CVD incidence rates in all C AC groups.
Impact of Cardiorespiratory Fitness on All-Cause and Disease-Specific Mortality: Advances Since 2009.
Cardiorespiratory Fitness and Reclassification of Risk for Incidence of Heart Failure: The Veterans Exercise Testing Study
TLDR
CRF is strongly, inversely, and independently associated with the incidence of HF in veterans referred for exercise testing in Veterans Affairs Medical Centers in Washington, DC and Palo Alto, CA.
Translating Research Into Clinical Practice: Importance of Improving Cardiorespiratory Fitness in Stroke Population.
TLDR
It is proposed that improving CRF is essential in stroke rehabilitation, particularly in acute and early subacute phase, and assessing CRF level and prescribing ET in clinical practice should be considered as a strategy to promote PA and ET in stroke population.
Implementing Cardiorespiratory Fitness as a Routine Measure in Health Care Settings
TLDR
The concept thatCRF can be substantially improved in response to regular exercise consistent with consensus recommendations underscores the recommendation that CRF should be a routine measure—a vital sign—across health care settings.
The genetic case for cardiorespiratory fitness as a clinical vital sign and the routine prescription of physical activity in healthcare
TLDR
Genetic evidence is found that genetic variants associated with CRF and PA influenced genetic expression in a relatively small set of genes in heart, artery, lung, skeletal muscle, and adipose tissue that were enriched among genes known to be associated with coronary artery disease, type 2 diabetes, and Alzheimer's disease.
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