Reference Standards for Cardiorespiratory Fitness by Cardiovascular Disease Category and Testing Modality: Data From FRIEND.

Peterman JE; Arena R; Myers J; Marzolini S; Ades PA; Savage PD; Lavie CJ;
Kaminsky LA

Journal of the American Heart Association. 10(22):e022336, 2021 11 16.
VI 1

Background The importance of cardiorespiratory fitness for stratifying
risk and guiding clinical decisions in patients with cardiovascular
disease is well-established. To optimize the clinical value of
cardiorespiratory fitness, normative reference standards are essential.
The purpose of this report is to extend previous cardiorespiratory fitness
normative standards by providing updated cardiorespiratory fitness
reference standards according to cardiovascular disease category and
testing modality. Methods and Results The analysis included 15 045 tests
(8079 treadmill, 6966 cycle) from FRIEND (Fitness Registry and the
Importance of Exercise National Database). Using data from tests conducted
January 1, 1974, through March 1, 2021, percentiles of directly measured
peak oxygen consumption (VO2peak) were determined for each decade from 30
through 89 years of age for men and women with a diagnosis of coronary
artery bypass surgery, myocardial infarction, percutaneous coronary
intervention, or heart failure. There were significant differences between
sex and age groups for VO2peak (P<0.001). The mean VO2peak was 23% higher
for men compared with women and VO2peak decreased by a mean of 7% per
decade for both sexes. Among each decade, the mean VO2peak from treadmill
tests was 21% higher than the VO2peak from cycle tests. Differences in
VO2peak were observed among the age groups in both sexes according to
cardiovascular disease category. Conclusions This report provides
normative reference standards by cardiovascular disease category for both
men and women performing cardiopulmonary exercise testing on a treadmill
or cycle ergometer. These updated and enhanced reference standards can
assist with patient risk stratification and guide clinical care.