Association between cardiorespiratory fitness levels and cardiometabolic risk factors among metropolitan police officers: a cross-sectional study

Police officers are at increased risk of cardiovascular disease due to shift work, high occupational stress, and prolonged sedentary patrol duties, which can negatively affect cardiorespiratory fitness (CRF). This risk is particularly important in Gauteng Province, South Africa, where CVD prevalence is high, and metropolitan police face unique urban and occupational challenges. Despite the physically demanding perception of law enforcement, CRF levels among metropolitan police officers (MPOs) remain underexplored. This study hypothesised that lower CRF would be associated with a higher prevalence of cardiometabolic risk factors in MPOs from Gauteng Province. This cross-sectional quantitative study included 187 purposively selected metropolitan police officers (116 males, 71 females; mean age 39.3 ± 8.2 years) from a municipality in Gauteng Province, South Africa, representing all police ranks. Participants completed informed consent and the Physical Activity Readiness Questionnaire (PAR-Q), with individuals having movement-limiting conditions, recent illness, pregnancy, or ≤ 2 months postpartum excluded. Ethical approval and municipal gatekeeper permission were obtained prior to data collection. Biochemical markers (total cholesterol, triglycerides, low- and high-density lipoprotein cholesterol, and fasting glucose), anthropometric measures (BMI and waist circumference), and blood pressure were assessed. Cardiorespiratory fitness was evaluated using a modified Harvard Step Test. Descriptive statistics were calculated using SPSS version 27.0 to summarize participant characteristics, while correlation analyses assessed associations between cardiorespiratory fitness and cardiometabolic risk factors, with statistical significance set at p ≤ 0.05. Significant sex differences were observed among 187 metropolitan police officers (62% males), with females showing higher BMI, obesity prevalence, waist circumference risk, and lower cardiorespiratory fitness (CRF), while males exhibited higher systolic blood pressure, lower HDL-C prevalence, and higher fitness scores (all p ≤ 0.05). Overall, CRF was significantly inversely associated with BMI, waist circumference, diastolic blood pressure, and triglycerides, with a borderline positive association with HDL-C. Sex-specific analyses showed inverse associations between CRF and BMI, and between CRF and waist circumference in both sexes, with additional significant associations for diastolic blood pressure in females and for triglycerides and HDL-C in males. Significant sex differences in cardiometabolic risk and cardiorespiratory fitness (CRF) were observed among metropolitan police officers, with higher CRF associated with more favourable cardiometabolic profiles. These findings highlight the need for sex-specific, structured fitness policies and routine fitness screening to mitigate cardiometabolic risk and support occupational readiness in police officers.