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Reference Standards for Cardiorespiratory Fitness Measured With Cardiopulmonary Exercise Testing
Open accessAbstract
Objective To develop standards for cardiorespiratory fitness by establishing reference values derived from cardiopulmonary exercise testing (CPX) in the United States.Patients and methods Eight laboratories in the US experienced in CPX administration with established quality control procedures contributed data from January 1, 2014, through February 1, 2015, from 7783 maximal (respiratory exchange ratio, ≥ 1.0) treadmill tests from men and women (aged 20-79 years) without cardiovascular disease (CVD) to the Fitness Registry and the Importance of Exercise: A National Data Base (FRIEND). Percentiles of maximal oxygen consumption (VO 2max) for men and women were determined for each decade from 20 years of age through 79 years of age. Comparisons of VO 2max were made to reference data established with CPX data from Norway and to US reference data established without CPX measurements.Results There were significant differences between sex and age groups for VO 2max. In FRIEND, the 50th percentile VO 2max of men and women aged 20 to 29 years decreased from 48.0 and 37.6 mLO2 · kg(-1) · min(-1) to 24.4 and 18.3 mLO2 · kg(-1) · min(-1) for ages 70 to 79 years, respectively. The rate of decline in this cohort during a 5-decade period was approximately 10% per decade.Conclusion These are the first cardiorespiratory fitness reference data using measures obtained from CPX in the United States. FRIEND can be used to provide a more accurate interpretation of measured VO 2max from maximal exercise tests for the US population compared with previous standards on the basis of workload-derived estimations.
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“For example, using the FRIEND database, “good” fitness for a 65-year-old man approximates ≥8.7 METs.”
From Physical activity, cardiorespiratory fitness, and cardiovascular health: A clinical practice statement of the American Society for Preventive Cardiology Part II: Physical activity, cardiorespiratory fitness, minimum and goal intensities for exercise training, prescriptive methods, and special patient populations (2022) · cites this paper as [59]
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“This analysis uniquely provides age-, sex-, and fitness-adjusted aerobic training intensities that are compatible with attaining cardioprotective levels of CRF.”
From Physical activity, cardiorespiratory fitness, and cardiovascular health: A clinical practice statement of the American Society for Preventive Cardiology Part II: Physical activity, cardiorespiratory fitness, minimum and goal intensities for exercise training, prescriptive methods, and special patient populations (2022) · cites this paper as [59]
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Metadata
- Authors
- Kaminsky, L. A., Arena, R., & Myers, J.
- Affiliations
- Ball State University (US)
- University of Illinois Chicago (US)
- VA Palo Alto Health Care System (US)
- Corresponding author
- Kaminsky, Leonard A.
- Venue
- Mayo Clinic Proceedings
- Publisher
- Elsevier BV
- Published
- 2015-11
- Volume
- 90
- Issue
- 11
- Pages
- 1515-1523
- ISSN
- 0025-6196 (ISSN-L)
- PMC
- PMC4919021
- OpenAlex
- W2765043188
- Cited by
- 461
- References
- 32
- Citations by year
- 2026: 26 · 2025: 42 · 2024: 49 · 2023: 48 · 2022: 71 · 2021: 57 · 2020: 55 · 2019: 46 · 2018: 33 · 2017: 17 · 2016: 15 · 2015: 2
- FWCI
- 43.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Mayo Clinic Proceedings (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Veterans Affairs (I01 RX000344, IK6 RX002477)
- Johns Hopkins University
- Ball State University
- Southern Connecticut State University
- National Institutes of Health (UL1TR000050)
- University of Illinois at Urbana-Champaign
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Health Professions › Medical Laboratory Technology › Clinical Laboratory Practices and Quality Control
- Keywords
- cardiorespiratory fitness, reference values, VO2max, cardiopulmonary exercise testing, treadmill exercise testing, age and sex differences
- MeSH terms
- Adult, Age Factors, Aged, Exercise Test, Female, Humans, Male, Middle Aged, Oxygen Consumption, Physical Fitness, Reference Values, Registries, Research, Sex Factors, United States, Cohort Studies
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