Physical activity and cardiorespiratory fitness as major markers of cardiovascular risk: their independent and interwoven importance to health status

Prog Cardiovasc Dis. 2015 Jan-Feb;57(4):306-14. doi: 10.1016/j.pcad.2014.09.011. Epub 2014 Sep 28.


The evolution from hunting and gathering to agriculture, followed by industrialization, has had a profound effect on human physical activity (PA) patterns. Current PA patterns are undoubtedly the lowest they have been in human history, with particularly marked declines in recent generations, and future projections indicate further declines around the globe. Non-communicable health problems that afflict current societies are fundamentally attributable to the fact that PA patterns are markedly different than those for which humans were genetically adapted. The advent of modern statistics and epidemiological methods has made it possible to quantify the independent effects of cardiorespiratory fitness (CRF) and PA on health outcomes. Based on more than five decades of epidemiological studies, it is now widely accepted that higher PA patterns and levels of CRF are associated with better health outcomes. This review will discuss the evidence supporting the premise that PA and CRF are independent risk factors for cardiovascular disease (CVD) as well as the interplay between both PA and CRF and other CVD risk factors. A particular focus will be given to the interplay between CRF, metabolic risk and obesity.

Keywords: ACSM; AHA; American College of Sports Medicine; American Heart Association; BMI; CDC; CHD; CRF; CT; CVD; Cardiorespiratory fitness; Cardiovascular risk; Centers for Disease Control; Diabetes; EPIC; European Prospective Investigation into Cancer and Nutrition; HF; HTN; MESA; MET; MI; Multi-ethnic Study of Atherosclerosis; NHS; Nurse's Health Study; Obesity; PA; PF; Physical activity; US; United States; VO(2); WHR; WISE; Women's Ischemic Syndrome Evaluation; body mass index; cardiorespiratory fitness; cardiovascular disease; computed tomography; coronary heart disease; heart failure; hypertension; metabolic equivalent; myocardial infarction; oxygen consumption; physical activity; physical fitness; waist-to-hip circumference ratio.

Publication types

  • Review

MeSH terms

  • Anthropology, Physical
  • Anthropometry / methods
  • Body Fat Distribution / methods
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / etiology
  • Cardiovascular Diseases* / prevention & control
  • Exercise
  • Health Status
  • Humans
  • Life Style*
  • Motor Activity / physiology*
  • Obesity, Abdominal* / complications
  • Obesity, Abdominal* / diagnosis
  • Obesity, Abdominal* / metabolism
  • Physical Fitness* / physiology
  • Physical Fitness* / psychology
  • Risk Factors