AHA proposes national registry on cardiorespiratory fitness

With a prevalence of CVD nearing 40% in those aged 60 years and 70% in older Americans, the American Heart Association cited the need for a national registry on cardiorespiratory fitness in a policy statement.

Cardiorespiratory fitness fitness levels and its components play a major role in the prevention and prediction of CVD. Currently, it's the "only major risk factor not routinely and regularly assessed in the general or specialized clinical setting," members of the American Heart Association Advocacy Coordinating Committee, Council on Clinical Cardiology and Council on Nutrition, Physical Activity and Metabolism, wrote in the policy statement published in Circulation. Cardiorespiratory fitness data acquisition are also limited and not strong, and there is a need to better define normal and criterion-based cardiorespiratory fitness standards. A national registry would enable the AHA to track these data and help Americans "achieve ideal cardiovascular health," committee members wrote.

There is one commonly referenced set of cardiorespiratory fitness classifications from the Cooper Institute in Dallas, which was established in approximately 1970. Data from the institute indicate that cardiorespiratory fitness is one of the strongest risk factors for CVD and all-cause mortality.

The committee proposes that the national registry focus on five major goals:

Determine normal adult cardiorespiratory fitness levels. As the population ages and becomes more overweight, understanding cardiorespiratory fitness in age, sex and body composition in a large sample of the population will enable clinicians to separate group-related differences in cardiorespiratory fitness levels from those related to disease.
Based on demographics, such as race and socioeconomic status, a registry will help determine cardiorespiratory fitness levels. This can help reduce disparities in CV health and disease across stratas.
A better understanding of normative cardiorespiratory fitness values by physical activity strata is reached. This leads to improved strategies for exercise prescription on a population level. A registry will define these levels.
Determine normative values of other non-cardiorespiratory fitness physiological parameters garnered from cardiopulmonary exercise testing. These values have important implications of information from non-cardiorespiratory fitness exercise testing parameters.
It will serve as a tracking device for cardiorespiratory fitness levels in the United States. As more campaigns are used to encourage physical activity, a registry will provide "a metric of their effectiveness," the committee wrote in the report. In addition, a registry will help identify trends in the general population and high-risk subgroups that might require further action.

Evidence exists that increasing cardiorespiratory fitness levels reduces risk for CVD and "dramatically improves prognosis," the report said. But national surveillance data, guidelines and recommendations available for traditional CVD risk factors are nonexistent for this important health metric.

Once the registry is established, value would be recognized immediately, the committee wrote. It could be incorporated into AHA annual statistical updates, create the ability to address clinically relevant research questions and provide needed cardiorespiratory fitness patterns in the public health arena. The registry would serve as a catalyst for new research endeavors and public policy initiatives.

For more information:

Kaminsky LA. Circulation. 2013;doi:10.1161/CIRC.0b013e31827ee100.

Disclosure: The researchers report no relevant financial disclosures.