Key result
Higher CRF is linked to a ~14% reduction in all-cause mortality per MET increase.
Why the study?
Cardiorespiratory fitness has gained attention as a predictor of cardiovascular and overall health, but its prognostic significance for cardiovascular risk and mortality requires synthesis.
Does higher cardiorespiratory fitness reduce the risk of cardiovascular events and mortality in adults?
Does higher cardiorespiratory fitness reduce the risk of cardiovascular events and mortality in adults?
Cardiorespiratory fitness is a strong, modifiable prognostic marker for cardiovascular and all-cause mortality that should be integrated into routine clinical risk assessment.
Supports CRF assessment in risk stratification; extends observational data but leaves open whether interventions improve survival.
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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Pietrończyk et al. (2026) conducted a review in Cardiovascular risk and mortality. Cardiorespiratory fitness vs. Lower cardiorespiratory fitness was evaluated. Higher cardiorespiratory fitness is consistently associated with lower mortality, with each 1-MET increase linked to an 11-17% reduction in all-cause mortality risk.
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