Cardiorespiratory Fitness Changes As A Function Of Baseline Fitness Level In An Unsupervised Training Program.

VO2 max is the most accurate measure of cardiorespiratory fitness and correlates with improved health outcomes throughout life, including lower cardiovascular disease mortality and reduced risk for hypertension, dyslipidemia, diabetes, and obesity. PURPOSE: To assess changes in cardiorespiratory fitness following an unsupervised exercise prescription in a preventive health clinic. METHODS: This retrospective observational analysis of participants in a preventive health clinic includes data from 397 patients between June 2016 and May 2023 at M Health Fairview of the University of Minnesota, 69 of whom underwent repeat VO2 max testing at a return visit. We followed demographics, height, weight, blood pressure, plasma glucose, lipids, comorbidities, and VO2 max. Patients were divided into 3 groups based on their percentile of VO2 max by age and sex. Statistical analysis data were expressed as means and standard deviations (SD) or percentages for continuous and categorical variables, respectively. Differences between continuous variables were determined with T-tests; chi-square analysis was employed to assess categorical values. RESULTS: Of the 397 participants, 91.2% were white, with a mean (SD) age of 49.8 (9.6). 53.7% had no comorbidities, 19.9% were overweight, 8.3% had obesity, 23.9% had hypertensive blood pressure values, 1.5% had diabetes, and 36.5% had dyslipidemia. Cardiorespiratory fitness was defined as Low (<25th percentile; n = 22), Fair to Good (>25th percentile to <75th percentile; n = 30), and Superior to Excellent (>75th percentile; n = 19). At baseline, 31% were in the low category of cardiorespiratory fitness. Among those who returned for a second evaluation, a mean (SD) 2.03 (1.05) years later, VO2 max fell by >10% in 15.5% of participants, did not change in 67.6% of individuals, and improved by >10% in 16.9%. The group with low cardiorespiratory fitness had the greater percentage of patients who decreased their VO2 max by >10% or changed by less than 10% (2 and 10 patients, respectively, out of 22). CONCLUSION: The low-fitness group (without overt disease) had the highest risk of future health issues and the most significant decline in cardiorespiratory fitness. We should target this population to identify strategies for improving cardiorespiratory fitness and reduce adverse health outcomes. "University of Minnesota's NIH Clinical and Translational Science Award: UL1TR002494."