CARDIORESPIRATORY FITNESS, VO2max, AND EXERCISE CAPACITY AS PREDICTORS OF CARDIOVASCULAR RISK AND MORTALITY: A NARRATIVE REVIEW

Jakub Pietrończyk; Krystian Kaczmarek; Zuzanna Wieczorek; Wiktoria Zawada; Iga Tartas; Vladyslav Romaniuk; Urszula Szuleta; Agnieszka Benecka; Alicja Benecka; Natalia Prankiewicz; Zofia Jadwiga Leszczyńska

doi:10.31435/ijitss.3(51).2026.6616

Authors

Jakub Pietrończyk University Clinical Hospital in Poznań, Przybyszewskiego 49, 60-355 Poznań, Poland https://orcid.org/0009-0006-6566-7537
Krystian Kaczmarek J. Strus City Multispecialty Hospital, Szwajcarska 3, 61-285 Poznań, Poland https://orcid.org/0009-0003-6026-1608
Zuzanna Wieczorek J. Strus City Multispecialty Hospital, Szwajcarska 3, 61-285 Poznań, Poland https://orcid.org/0009-0005-9952-780X
Wiktoria Zawada J. Strus City Multispecialty Hospital, Szwajcarska 3, 61-285 Poznań, Poland https://orcid.org/0009-0007-5871-2640
Iga Tartas J. Strus City Multispecialty Hospital, Szwajcarska 3, 61-285 Poznań, Poland https://orcid.org/0009-0007-5602-2259
Vladyslav Romaniuk Prof. S. T. Dąbrowski Hospital in Puszczykowo S.A., 11 Józefa Ignacego Kraszewskiego Street, 62-040 Puszczykowo, Poland https://orcid.org/0009-0002-9674-4188
Urszula Szuleta J. Strus City Multispecialty Hospital, Szwajcarska 3, 61-285 Poznań, Poland https://orcid.org/0009-0004-1795-7439
Agnieszka Benecka J. Strus City Multispecialty Hospital, Szwajcarska 3, 61-285 Poznań, Poland https://orcid.org/0009-0004-9295-7471
Alicja Benecka Prof. S. T. Dąbrowski Hospital in Puszczykowo S.A., 11 Józefa Ignacego Kraszewskiego Street, 62-040 Puszczykowo, Poland https://orcid.org/0009-0000-5110-8028
Natalia Prankiewicz University Center of Dentistry and Specialized Medicine in Poznań, Bukowska 70, 60-812 Poznań, Poland https://orcid.org/0009-0007-5865-7063
Zofia Jadwiga Leszczyńska J. Strus City Multispecialty Hospital, Szwajcarska 3, 61-285 Poznań, Poland https://orcid.org/0009-0009-4584-1130

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.6616

Keywords:

Cardiorespiratory Fitness, VO2max, Exercise Capacity, Cardiovascular Risk, Mortality, Physical Activity

Abstract

Background. Cardiovascular disease is one of the leading causes of morbidity and mortality worldwide. Physical inactivity and sedentary behavior are important modifiable risk factors. Cardiorespiratory fitness (CRF), often expressed as VO2max, VO2peak, metabolic equivalents (METs), exercise capacity, or estimated CRF, has gained attention as a predictor of cardiovascular and overall health.

Aim. This review evaluated the prognostic significance of CRF in relation to cardiovascular risk, cardiovascular outcomes, cardiovascular mortality, all-cause mortality, and premature mortality in adults.

Materials and methods. This narrative review was based on English-language publications identified in PubMed and Google Scholar. Meta-analyses, systematic reviews, observational cohort studies, clinical reviews, expert statements, and interventional studies relevant to cardiorespiratory fitness, exercise capacity, cardiovascular prevention, mortality, and cardiac rehabilitation were included in the synthesis.

Results. The reviewed evidence consistently indicates that higher CRF is associated with a lower risk of all-cause mortality, cardiovascular mortality, and cardiovascular events. This relationship has been observed using various assessment methods, including directly measured VO2max or VO2peak, treadmill-derived peak METs, exercise capacity, and estimated CRF. CRF also appears to have prognostic value in populations with obesity, diabetes, hypertension, coronary artery disease, and heart failure. Changes in CRF over time may be associated with changes in mortality risk. These findings support the interpretation of CRF as a modifiable prognostic marker.

Conclusions. CRF should be regarded as a measure of physical performance as well as an indicator of cardiovascular, respiratory, metabolic, and functional health. Its assessment may support cardiovascular risk stratification, prevention, and rehabilitation strategies in adult populations.

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