RT journal article
T1 Comparison of objectively measured and estimated cardiorespiratory fitness to predict all-cause and cardiovascular disease mortality in adults: A systematic review and meta-analysis of 42 studies representing 35 cohorts and 3.8 million observations
A1 Singha, Ben
A1 Cadenas Sánchez, Cristina
A1 Costaf, Bruno G.G.da
A1 Castro Piñero, José
A1 Chaputi, Jean-Philippe
A1 Cuenca García, María Magdalena
A1 Mahera, Carol
A1 Marín Jiménez, Nuria
A1 McGratha, Ryan
A1 Molina-Garcia, Pablo
A1 Myers, Jonathan
A1 Gowera, Bethany
A1 Ortega, Francisco B
A1 Langa, Justin J.
A1 Tomkinson, Grant R.
A2 Didáctica de la Educación FísicaPlástica y Musical
K1 Cardiorespiratory fitness
K1 Cardiovascular diseases
K1 Cohort studies
K1 Risk assessment
K1 Adult
AB Background: Cardiorespiratory fitness (CRF) is a powerful health marker recommended by the American Heart Association as a clinical vital sign. Comparing the predictive validity of objectively measured CRF (the “gold standard”) and estimated CRF is clinically relevant because estimated CRF is more feasible. Our objective was to meta-analyze cohort studies to compare the associations of objectively measured, exerciseestimated, and non-exercise-estimated CRF with all-cause and cardiovascular disease (CVD) mortality in adults. Methods: Systematic searches were conducted in 9 databases (MEDLINE, SPORTDiscus, Embase, Scopus, PsycINFO, Web of Science, PubMed, CINAHL, and the Cochrane Library) up to April 11, 2024. We included full-text refereed cohort studies published in English that quantified the association (using risk estimates with 95% confidence intervals (95%CIs)) of objectively measured, exercise-estimated, and non-exercise-estimated CRF with all-cause and CVD mortality in adults. CRF was expressed as metabolic equivalents (METs) of task. Pooled relative Peer review under responsibility of Shanghai University of Sport. * Corresponding author. E-mail address: ben.singh@unisa.edu.au (B. Singh). https://doi.org/10.1016/j.jshs.2024.100986 Cite this article: Singh B, et al. Comparison of objectively measured and estimated cardiorespiratory fitness to predict all-cause and cardiovascular disease mortality in adults: A systematic review and meta-analysis of 42 studies representing 35 cohorts and 3.8 million observations, J Sport Health Sci 2025;14:100986 1J Sport Health Sci 2025;14:100986 B. Singh et al. risks (RR) for all-cause and CVD mortality per 1-MET (3.5 mL/kg/min) higher level of CRF were quantified using random-effects models. Results: Forty-two studies representing 35 cohorts and 3,813,484 observations (81% male) (362,771 all-cause and 56,471 CVD deaths) were included. The pooled RRs for all-cause and CVD mortality per higher MET were 0.86 (95%CI: 0.83 0.88) and 0.84 (95%CI: 0.80 0.87), respectively. For both all-cause and CVD mortality, there were no statistically significant differences in RR per higher MET between objectively measured (RR range: 0.86 0.90) and maximal exercise-estimated (RR range: 0.85 0.86), submaximal exercise-estimated (RR range: 0.91 0.94), and non-exercise-estimated CRF (RR range: 0.81 0.85). Conclusion: Objectively measured and estimated CRF showed similar dose response associations for all-cause and CVD mortality in adults. Estimated CRF could provide a practical and robust alternative to objectively measured CRF for assessing mortality risk across diverse populations. Our findings underscore the health-related benefits of higher CRF and advocate for its integration into clinical practice to enhance risk stratification.
PB Elsevier
SN 2213-2961
YR 2025
FD 2025
LK http://hdl.handle.net/10498/36353
UL http://hdl.handle.net/10498/36353
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 21-sep-2026