Abstract
PurposeCardiorespiratory fitness is inversely associated with a high risk of cardiovascular disease, all-cause mortality, and mortality attributable to various cancers. It is often estimated indirectly using mathematical formulas for estimating oxygen uptake. Cardiopulmonary exercise testing, especially oxygen uptake, represents the “gold standard” for assessing exercise capacity. The purpose of this report was to develop reference standards for exercise capacity by establishing cardiorespiratory fitness values derived from cardiopulmonary exercise testing in a Brazilian population. We focused on oxygen uptake standards and compared the maximal oxygen uptake [mLO2·kg-1·min-1] values with those in the existing literature.MethodsA database was constructed using reports from cardiopulmonary exercise testing performed at Fleury laboratory. The final cohort included 18,189 individuals considered to be free of structural heart disease. Percentiles of maximal oxygen uptake for men and women were determined for six age groups between 7 and 84 years. We compared the values with existing reference data from patients from Norway and the United States.ResultsThere were significant differences in maximal oxygen uptake between sexes and across the age groups. In our cohort, the 50th percentile maximal oxygen uptake values for men and women decreased from 44.7 and 36.3 mLO2·kg-1·min-1 to 28.4 and 22.3 mLO2·kg-1·min-1 for patients aged 20–29 years to patients aged 60–69 years, respectively. For each age group, both Norwegian men and women had greater cardiorespiratory fitness than cohorts in the United States and Brazil.ConclusionTo our knowledge, our analysis represents the largest reference data for cardiorespiratory fitness based on treadmill cardiopulmonary exercise testing. Our findings provide reference values of maximal oxygen uptake measurements from treadmill tests in Brazilian populations that are more accurate than previous standard values based on workload-derived estimations. This data may also add information to the global data used for the interpretation of cardiorespiratory fitness.
Highlights
Oxygen uptake (VO2max) is considered to be the most important parameter associated with an individual’s physical conditioning, and it is an objective and independent prognostic indicator for cardiovascular disease [1]
Our analysis represents the largest reference data for cardiorespiratory fitness based on treadmill cardiopulmonary exercise testing
Our findings provide reference values of maximal oxygen uptake measurements from treadmill tests in Brazilian populations that are more accurate than previous standard values based on workload-derived estimations
Summary
Oxygen uptake (VO2max) is considered to be the most important parameter associated with an individual’s physical conditioning, and it is an objective and independent prognostic indicator for cardiovascular disease [1]. Cardiorespiratory fitness (CRF) is inversely associated with a high risk of cardiovascular disease, all-cause mortality, and mortality attributable to various cancers [2]. Improvements in CRF are associated with reduced mortality risk, and small increases in CRF (e.g., 1–2 METs) are associated with considerably lower (10–30%) adverse cardiovascular event rates [2,3]. CRF is often estimated indirectly using mathematical formulas to estimate VO2 uptake. It is very important to have accurate reference values for CRF owing to the relevance of CRF in estimating health risks, since CRF varies according to age, sex, and population [2]
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