The Importance of Cardiorespiratory Fitness in the United States: The Need for a National Registry

Kaminsky, Leonard A.; Arena, Ross; Beckie, Theresa M.; Brubaker, Peter H.; Church, Timothy S.; Forman, Daniel E.; Franklin, Barry A.; Gulati, Martha; Lavie, Carl J.; Myers, Jonathan; Patel, Mahesh J.; Piña, Ileana L.; Weintraub, William S.; Williams, Mark A.

doi:10.1161/cir.0b013e31827ee100

Cited by 326 publications

(232 citation statements)

References 95 publications

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“…The magnitude of improvement is similar to that reported by Niederseer et al [25] and Lira et al [39] who both report ~7% improvements in relative V O in cohorts of older adults following 12 weeks of alpine skiing and moderate treadmill running respectively. This increase, although modest, would still represent a significant reduction in mortality risk [30] as it approximates 0.6 METs in older males [40]. Similarly, the ~2% decrease in body fat percentage observed in SED is in line with a previous investigation [25] which reported a of 2.3% reduction following 12 weeks of alpine skiing.…”

Section: Resultssupporting

confidence: 85%

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Six weeks of conditioning exercise increases total, but not free testosterone in lifelong sedentary aging men

et al. 2015

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, Fergal M. (2015) Six weeks of conditioning exercise increases total, but not free testosterone in lifelong sedentary aging men. Aging Male, Downloaded from: http://insight.cumbria.ac.uk/1832/ Usage of any items from the University of Cumbria's institutional repository 'Insight' must conform to the following fair usage guidelines.Any item and its associated metadata held in the University of Cumbria's institutional repository Insight (unless stated otherwise on the metadata record) may be copied, displayed or performed, and stored in line with the JISC fair dealing guidelines (available here) for educational and not-for-profit activities provided that• the authors, title and full bibliographic details of the item are cited clearly when any part of the work is referred to verbally or in the written form• a hyperlink/URL to the original Insight record of that item is included in any citations of the work • the content is not changed in any way• all files required for usage of the item are kept together with the main item file. You may not• sell any part of an item• refer to any part of an item without citation • amend any item or contextualise it in a way that will impugn the creator's reputation• remove or alter the copyright statement on an item. AbstractIntroduction: Advancing age is associated with a gradual decline in circulating androgens and the putative role of exercise training on systemic androgens remain to be adequately defined. Results: Analysis of variance (ANOVA) revealed a lack of significant change in any parameter amongst LE whilst SED experienced a significant exercise-induced improvement in cardiorespiratory fitness, and total testosterone (all p<0.05). Concurrent increases in sex hormone-binding globulin (SHBG; p<0.05) resulted in a lack of change to either bioavailable or calculated free testosterone (p>0.05) amongst SED. MethodsConclusions: Although resting levels of systemic total testosterone increased in response to six weeks of exercise training, increases in SHBG negated any potential relationship between calculated-free or bioavailable testosterone. These findings indicate that increases in bioavailable testosterone fraction are not required for cardiorespiratory fitness improvements in aging men.

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Section: Resultssupporting

confidence: 85%

“…Modest increases in CRF are associated with lower mortality risk [29], such that one metabolic equivalent (MET) increase in peak oxygen uptake (V O [an increment achievable by most sedentary individuals, healthy or otherwise]) can produce considerable (10%-25%) improvement in survival [30].…”

Section: Introductionmentioning

confidence: 99%

Six weeks of conditioning exercise increases total, but not free testosterone in lifelong sedentary aging men

et al. 2015

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“…As noted in numerous recent American Heart Association scientific statements, the measurement of CRF in clinical settings is both important and feasible. 74,75,152,153,292 Additionally, estimates of CRF using nonexercise algorithms have pragmatic importance and provide values for CRF that enhance risk prediction when direct CRF measures are not feasible. In fact, routine estimation of CRF in clinical practice is CRF indicates cardiorespiratory fitness; CVD, cardiovascular disease; HRR, heart rate reserve; MET, metabolic equivalents; and V no more difficult than measuring blood pressure, and procedures for incorporating CRF estimation into routine clinical assessments in a pragmatic manner are provided in Tables 9 and 10.…”

Section: Discussionmentioning

confidence: 99%

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

Ross¹,

Blair²,

Arena³

et al. 2016

Circulation

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ABSTRACT: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 to traditional risk factors significantly improves the reclassification of risk for adverse outcomes. The purpose of this statement is to review current knowledge related to the association between CRF and health outcomes, increase awareness of the added value of CRF to improve risk prediction, and suggest future directions in research. Although the statement is not intended to be a comprehensive review, critical references that address important advances in the field are highlighted. The underlying premise of this statement is that the addition of CRF for risk classification presents health professionals with unique opportunities to improve patient management and to encourage lifestyle-based strategies designed to reduce cardiovascular risk. These opportunities must be realized to optimize the prevention and treatment of cardiovascular disease and hence meet the American Heart Association's 2020 goals.M ounting evidence over the past 3 decades has firmly established that low levels of cardiorespiratory fitness (CRF) are associated with a high risk of cardiovascular disease (CVD) and all-cause mortality, as well as mortality rates attributable to various cancers, especially of the breast and colon/digestive tract. [1][2][3][4] Importantly, improvements in CRF are associated with reduced mortality risk.5 Although CRF is now recognized as an important marker of cardiovascular health, it is currently the only major risk factor not routinely assessed in clinical practice.In 2013, the American Heart Association and the American College of Cardiology jointly released new guidelines for the prevention and treatment of coronary artery disease.6 Although CRF is the fourth-leading risk factor for CVD and has long been established as a significant prognostic marker, 7 it was excluded from the risk calculator. The authors of the guidelines noted that the evidence that CRF would enhance risk classification was inconclusive, and thus, the added contribution of CRF to determine CVD risk was uncertain. There is, however, a large body of epidemiological and clinical evidence demonstrating 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 (T2DM), but that the addition of CRF to traditional risk factors significantly improves the reclassification of risk for adverse outcomes.

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“…30 The statement emphasized the importance of creating a formal multicenter cardiorespiratory fitness database to provide a sufficiently representative sample of the population. 30 Furthermore, they also stressed the necessity of clearly defining levels of cardiorespiratory fitness in order to standardize studies across different subgroups and locations. 30 Overall, epidemiological studies of cardiorespiratory fitness provide reasonably convincing evidence of an independent association with the risk of CVD.…”

mentioning

confidence: 99%

“…30 Furthermore, they also stressed the necessity of clearly defining levels of cardiorespiratory fitness in order to standardize studies across different subgroups and locations. 30 Overall, epidemiological studies of cardiorespiratory fitness provide reasonably convincing evidence of an independent association with the risk of CVD. However, additional studies are needed in order to determine whether or not cardiorespiratory fitness is an independent, novel risk marker for CVD that adds clinical value.…”

mentioning

confidence: 99%

Behavioral Cardiovascular Risk Factors　– Effect of Physical Activity and Cardiorespiratory Fitness on Cardiovascular Outcomes –

Spencer

Heidecker

Ganz

2016

Circ J

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34SPENCER RM et al. Circulation JournalOfficial Journal of the Japanese Circulation Society http://www. j-circ.or.jp CVD and stroke by 20%." 4 The committee was tasked with defining cardiovascular health, a concept that encompasses the presence of 7 ideal health behaviors and factors, including physical activity level. Thus, the AHA claims that cardiorespiratory fitness is an uncertain risk factor, but physical activity at goal levels is an ideal health behavior. This review aims to distinguish physical activity from physical fitness, more specifically cardiorespiratory fitness, as well as to address the question whether physical inactivity and cardiorespiratory fitness are independent risk factors for CVD. Definition of TermsAlthough physical activity, exercise, and physical fitness are closely related, they are distinct and require unique assessment methods. Physical activity is defined as "any bodily movement produced by skeletal muscles that results in energy expenditure." 5 Physical activity is measured via criterion methods, objective methods, and subjective methods. 6 Criterion methods include doubly labeled water, indirect calorimetry, and the gold standard, direct calorimetry. Doubly labeled water measures metabolic rate and requires ingesting 2 isotopes of water and assessing the difference in elimination rates of the isotopes over a certain time period. 6 Indirect calorimetry uses oxygen consumption or carbon dioxide elimination to indirectly estimate energy expenditure, while direct calorimetry measures energy expenditure through heat production. 6 Objective methods of physical activity include pedometers, accelerometers, espite major improvements in its treatment, cardiovascular disease (CVD) remains the leading cause of death worldwide. 1,2 In 2012, 17.5 million people died of CVD and this figure is expected to grow to 23.6 million by 2030. 2 Thus, understanding risk factors is integral to the prevention of CVD-related morbidity and mortality. Preserving cardiovascular health and treating modifiable risk factors instead of advanced disease benefits the long-term health of patients. Models for risk prediction have evolved since cardiovascular epidemiology began in the 1930 s. Various 5-and 10-year risk prediction models have been widely adopted, and include common variables such as age, sex, cholesterol, smoking status, diabetes, and systolic and diastolic blood pressures (SBP, DBP). However, despite abundant research focused on understanding the effect of physical activity and fitness on cardiovascular outcomes, these risk models do not include physical activity or fitness. In 2013, the American College of Cardiology/American Heart Association (ACC/AHA) Work Group examined the contribution of potential risk markers, including cardiorespiratory fitness, to risk assessment or reclassification when added to traditional variables. 3 At that time, they concluded that the evidence for contribution of cardiorespiratory fitness to risk assessment for a first atherosclerotic CVD event was inconclusive. 3 Wh...

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The Importance of Cardiorespiratory Fitness in the United States: The Need for a National Registry

Cited by 326 publications

References 95 publications

Six weeks of conditioning exercise increases total, but not free testosterone in lifelong sedentary aging men

Six weeks of conditioning exercise increases total, but not free testosterone in lifelong sedentary aging men

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

Behavioral Cardiovascular Risk Factors　– Effect of Physical Activity and Cardiorespiratory Fitness on Cardiovascular Outcomes –

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The Importance of Cardiorespiratory Fitness in the United States: The Need for a National Registry

Cited by 326 publications

References 95 publications

Six weeks of conditioning exercise increases total, but not free testosterone in lifelong sedentary aging men

Six weeks of conditioning exercise increases total, but not free testosterone in lifelong sedentary aging men

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

Behavioral Cardiovascular Risk Factors – Effect of Physical Activity and Cardiorespiratory Fitness on Cardiovascular Outcomes –

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Behavioral Cardiovascular Risk Factors　– Effect of Physical Activity and Cardiorespiratory Fitness on Cardiovascular Outcomes –