Cardiorespiratory Fitness and Mortality Risk

In the last years fitness lifestyle has increased around the world thanks to the diffusion of the media, and obviously for the benefit that it carries. Reaching a healthy weight, glucose control, cardiovascular benefits and emotional regulation are some of the benefits of fitness. 

Cardiorespiratory fitness (CRF) emerged as a stronger predictor of all-cause mortality than did any traditional risk factor across the spectrum of age, sex, and race in a modeling study that included more than 750,000 US veterans.

Peter Kokkinos, PhD, Rutgers University, New Brunswick, New Jersey, and the VA Medical Center, Washington DC, and his team did a study to see if cardiorespiratory exercise has an improvement on longevity and if extreme exercise is related with mortality risk. 

The team analyzed data from the VA’s Exercise Testing and Health Outcomes Study (ETHOS) on individuals aged 30-95 years who underwent exercise treadmill tests (ETTs) between 1999 and 2020.

They included 750,302 individuals: 6.5% were women; 73.7% were White individuals; 19% were African American individuals; 4.7% were Hispanic individuals; and 2.1% were Native American, Asian, or Hawaiian individuals. Septuagenarians made up 14.7% of the cohort, and octogenarians made up 3.6%. They get blood pressure,  heart rate,  and a response if you’re not doing exercise. 

Their findings are that  higher exercise capacity was inversely related to mortality risk across the cohort and within each age category. Specifically, every 1 MET increase in exercise capacity yielded an adjusted hazard ratio (HR) for mortality of 0.86 for the entire cohort and similar HRs by sex and race.

The mortality risk for the least-fit individuals was fourfold higher than for extremely fit individuals (HR, 4.09), with the lowest mortality risk at about 14.0 METs for both men (HR, 0.24) and women (HR, 0.23). 

In addition, at 20 years of follow-up, about 80% of men and 95% of women in the highest CRF category were alive vs less than 40% of men and approximately 75% of women in the least fit CRF category.

This study shows huge information about the long-term benefit of having a healthy lifestyle. It is important that the physicians give more importance and prescribe aerobic exercise as part of the treatment for the patients.


Peter Kokkinos, Charles Faselis, Immanuel Babu Henry Samuel, Andreas Pittaras, Michael Doumas, Rayelynn Murphy, Michael S. Heimall, Xuemei Sui, Jiajia Zhang, and Jonathan Myers (August , 2022). Cardiorespiratory Fitness and Mortality Risk Across the Spectra of Age, Race, and Sex. Journal of American College of Cardiology. Retrieved from: 


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