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Should Aerobic Fitness Be Considered a Vital Sign?
NorthCascades
Posts: 10,968 Member
Vital signs are measurements of the basic human bodily functions required for life. There are four main vital signs regularly monitored by health professionals:
* Pulse – The rhythm of the heart as it pushes out and takes in blood
* Blood Pressure – The force of blood as it pushes against the walls of arteries
* Respiration – The number of natural breaths per minute
* Body Temperature – The internal, overall temperature of the body
Physicians, dentists, and other healthcare providers use vital signs to help diagnose medical problems. However, there may be other measures of human life that can help medical science progress in the field of diagnosis, especially when doctors seek ways to detect and treat problems with vital organs.
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According to the American Heart Association, low levels of cardiorespiratory fitness (CRF) are associated with high risk of cardiovascular disease, death, and cancer. Researchers believe that clinical evidence has demonstrated the potential strength of CRF is greater than traditional risk factors such as smoking, hypertension, and diabetes at predicting mortality. This evidence may make it one of the best early signs for recognizing impending heart disease.
The organization recommends that physicians begin measuring aerobic fitness as soon as possible.
https://www.helprx.info/blog/heart-health/heart-health-should-aerobic-fitness-be-a-vital-sign
* Pulse – The rhythm of the heart as it pushes out and takes in blood
* Blood Pressure – The force of blood as it pushes against the walls of arteries
* Respiration – The number of natural breaths per minute
* Body Temperature – The internal, overall temperature of the body
Physicians, dentists, and other healthcare providers use vital signs to help diagnose medical problems. However, there may be other measures of human life that can help medical science progress in the field of diagnosis, especially when doctors seek ways to detect and treat problems with vital organs.
...
According to the American Heart Association, low levels of cardiorespiratory fitness (CRF) are associated with high risk of cardiovascular disease, death, and cancer. Researchers believe that clinical evidence has demonstrated the potential strength of CRF is greater than traditional risk factors such as smoking, hypertension, and diabetes at predicting mortality. This evidence may make it one of the best early signs for recognizing impending heart disease.
The organization recommends that physicians begin measuring aerobic fitness as soon as possible.
https://www.helprx.info/blog/heart-health/heart-health-should-aerobic-fitness-be-a-vital-sign
2
Replies
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Probably a good idea. People won't like it though. A medical professional can't fix poor aerobic fitness with a pill, people have to move their *kitten*.8
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My initial thought was no, because I assumed measuring it would require some type of aerobic activity and that just seems impractical at every vital sign reading. I sure wouldn't want to go through that every time I went to the dentist or GYN. But after reading this - but an increasing number of fitness calculators are providing more accurate estimates of physical fitness without the need to stimulate aerobic activity in patients - in the article, I'm not sure. I'd need to know what was involved.
Waist measurement is also an important health marker but it very rarely measured even though it's a very simple process. But so many patient refuse it that most doctors don't even ask.0 -
@Need2Exerc1se I was curious about that, too.
The article links to a questionnaire, which asks: sex, age, height, weight, max heart rate (which it will estimate if necessary), how often you exercise (multiple choice), whether a typical workout is more or less than 30 minutes, whether there's no or some or lots of sweat and panting in a typical workout, your waistline measurement, and resting heart rate (which a phone camera can measure).
From that it estimates your VO2max. It was a few points high for mine.0 -
NorthCascades wrote: »@Need2Exerc1se I was curious about that, too.
The article links to a questionnaire, which asks: sex, age, height, weight, max heart rate (which it will estimate if necessary), how often you exercise (multiple choice), whether a typical workout is more or less than 30 minutes, whether there's no or some or lots of sweat and panting in a typical workout, your waistline measurement, and resting heart rate (which a phone camera can measure).
From that it estimates your VO2max. It was a few points high for mine.
Oh yeah, I did the questionnaire (I am a sucker for online questionnaires). IDK what my real VO2 max is but it said mine was 17 years younger than my actual age so I hope it's correct, or at least close.
I didn't realize that's what they meant by a calculator.0 -
That calculator tells me:
I'm 45, but have an expected fitness level of 46 VO2max;
However, I have the fitness of an average 35 yo, with actual fitness level of 50 VO2max.
KEEP ON GOING! Your fitness level is good for your age and gender.
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I think this is a great idea; however from personal experience the vast majority of people lie on medical intake. Nearly everyone reports that they eat healthy and exercise. Funny as those who report that they don't are usually in much better shape.2
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I think this is a great idea; however from personal experience the vast majority of people lie on medical intake. Nearly everyone reports that they eat healthy and exercise. Funny as those who report that they don't are usually in much better shape.
Pretty much this, though I'm rather chuffed at what it had to say to me about my fitness level. I had to fudge one answer since I don't sweat, but I do breathe heavy during exercise. It's a weird thing, my daughter has the same issue. I don't sweat when I get hot either. Only my hands sweat.
Also, in spite of having put on some weight recently, I do weigh significantly less than I did when I was 18, a fact which agreeing to answering the extra questions reminded me of. It's given me some much-needed perspective.1 -
I think this is a great idea; however from personal experience the vast majority of people lie on medical intake. Nearly everyone reports that they eat healthy and exercise. Funny as those who report that they don't are usually in much better shape.
I don't know how this would actually work on the ground, and I guess the devil is in the details (as always).
I expect I'd be able to show my doctor what my Garmin/Firstbeat calculated my VO2max to be during exercise (running or cycling) and skip the questionnaire. Can't type a number into my watch, I can only let it calculate one. But who knows, doctor's offices might not trust numbers they don't know the provenance of.0 -
Isn't aerobic fitness measured during a stress test (when they put you on a treadmill and monitor your vitals)?
Granted, I know it isn't a common test unless you've already been diagnosed with heart disease. Even then, insurance won't cover it in the US unless you have other symptoms like chest pain.0 -
@WickedPineapple
Yes, exactly. The idea is that the results of that sort of test (or calculation) are useful for diagnosing all sorts of medical problems.
Your cardiovascular system relies on a whole lot of stuff in your body all working properly together. Which means good CV fitness is good overall health. See: http://circ.ahajournals.org/content/134/24/e653
CRF reflects the integrated ability to transport oxygen from the atmosphere to the mitochondria to perform physical work. It therefore quantifies the functional capacity of an individual and is dependent on a linked chain of processes that include pulmonary ventilation and diffusion, right and left ventricular function (both systole and diastole), ventricular-arterial coupling, the ability of the vasculature to accommodate and efficiently transport blood from the heart to precisely match oxygen requirements, and the ability of the muscle cells to receive and use the oxygen and nutrients delivered by the blood, as well as to communicate these metabolic demands to the cardiovascular control center. Clearly, CRF is directly related to the integrated function of numerous systems, and it is thus considered a reflection of total body health. About half of the variance in CRF is considered to be attributable to heritable factors9; similarly, the contribution of inherited factors to the response of CRF to physical activity approximates 45% to 50%.10 It is noteworthy that these heritability estimates are similar in magnitude to other CVD risk factors, including, for example, insulin, glucose, lipoproteins, blood pressure, and high-sensitivity C-reactive protein.112 -
The company I work for does. It does it for 90 days, so you won't be asked about it every visit
We ask how many days/ mins a week. Vitals are much better on people who workout regularly.0 -
GottaBurnEmAll wrote: »I think this is a great idea; however from personal experience the vast majority of people lie on medical intake. Nearly everyone reports that they eat healthy and exercise. Funny as those who report that they don't are usually in much better shape.
Pretty much this, though I'm rather chuffed at what it had to say to me about my fitness level. I had to fudge one answer since I don't sweat, but I do breathe heavy during exercise. It's a weird thing, my daughter has the same issue. I don't sweat when I get hot either. Only my hands sweat.
Also, in spite of having put on some weight recently, I do weigh significantly less than I did when I was 18, a fact which agreeing to answering the extra questions reminded me of. It's given me some much-needed perspective.
The question I found very odd on the calculator was how often do you eat "High-fat fish on bread for dinner". I eat high fat fish fairly often, but rarely on bread. I can't remember now how I answered it.0 -
WickedPineapple wrote: »Isn't aerobic fitness measured during a stress test (when they put you on a treadmill and monitor your vitals)?
Granted, I know it isn't a common test unless you've already been diagnosed with heart disease. Even then, insurance won't cover it in the US unless you have other symptoms like chest pain.
Or you are old(ish) and need surgery unrelated to your heart. At least that was the case with me. They wouldn't spring for the nuclear test (with dye) but they did cover a treadmill stress test and ECG though.0 -
Calculator makes me LOL:
I'm 61, with an expected fitness level of 32 VO2max;
However, I have the fitness of a < 20 y/o (!?!) with actual fitness level of 45 VO2max.
(Yes, I gave honest answers.)
The results? I kinda doubt it. But if they want to base my health insurance premiums on these numbers, I'm all for it.
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Not sure about the calculator...it says I have fitness of a 23yr old! (I'm 43) I even did all the extra questions so the calculator knew I have asthma. I'm not sure I believe it as I know my health is poor by my standards. I'm nowhere near where I was just a few years ago.
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I think it makes sense to pay attention to aerobic fitness level as a medical indicator. That would provide more insight into how healthy someone is, see if they are deteriorating or improving, etc.
But it seems to me that aerobic fitness doesn't really fit in with the other vital signs. The other ones mentioned - pulse, blood pressure, respiration, and temperature - are all easily and rapidly measurable. They can even be measured when the subject is unconscious. VO2max requires either a stress test or, as discussed in the article, a calculator that is subject to all kinds of uncertainties.0 -
Not sure about the calculator...it says I have fitness of a 23yr old! (I'm 43) I even did all the extra questions so the calculator knew I have asthma. I'm not sure I believe it as I know my health is poor by my standards. I'm nowhere near where I was just a few years ago.
Your standards are a lot higher than most. Somebody my girlfriend works with was talking about visiting Iceland on a cruise. She'd like to soak in a hot spring, but it's a mile from the road. She explained that it's ok, because they have helicopters (to carry her that mile).0 -
I think it makes sense to pay attention to aerobic fitness level as a medical indicator. That would provide more insight into how healthy someone is, see if they are deteriorating or improving, etc.
But it seems to me that aerobic fitness doesn't really fit in with the other vital signs. The other ones mentioned - pulse, blood pressure, respiration, and temperature - are all easily and rapidly measurable. They can even be measured when the subject is unconscious. VO2max requires either a stress test or, as discussed in the article, a calculator that is subject to all kinds of uncertainties.
I agree. If the calculator uses an estimated max heart rate based on age related formulas, it's pretty much useless. Using unreliable formulas as a means of diagnosing one's health condition is pretty dangerous, IMO.1 -
That was fun! I'm 66, my expected VO2max is 60, but mine is estimated at 62. I have the fitness of an average 60 year old which is encouraging. If I had taken it last year before I started losing weight and exercising I think it might have been closer to 70.
My takeaway is that the estimates correspond roughly to the level of fitness and health I'm experiencing. I'm far healthier than I was a year ago, but I'm far from an athlete and while I'm at a healthy weight I'm still at around 33% body fat (calipers). It would be interesting to take this test next year assuming I continue to improve my fitness, and compare the results.
I would honestly hate to see insurance premiums based on a survey like this. I can see so many variables that would skew the results, mostly toward the negative, and from experience know that these types of surveys are far more likely to be used to jack up insurance premiums or deny life insurance (for instance, I've been denied life insurance by my husband's company because I consulted a doctor for depression and anxiety).1 -
lporter229 wrote: »I think it makes sense to pay attention to aerobic fitness level as a medical indicator. That would provide more insight into how healthy someone is, see if they are deteriorating or improving, etc.
But it seems to me that aerobic fitness doesn't really fit in with the other vital signs. The other ones mentioned - pulse, blood pressure, respiration, and temperature - are all easily and rapidly measurable. They can even be measured when the subject is unconscious. VO2max requires either a stress test or, as discussed in the article, a calculator that is subject to all kinds of uncertainties.
I agree. If the calculator uses an estimated max heart rate based on age related formulas, it's pretty much useless. Using unreliable formulas as a means of diagnosing one's health condition is pretty dangerous, IMO.
Do you think a best guess is worse than no information at all?0 -
I would honestly hate to see insurance premiums based on a survey like this. I can see so many variables that would skew the results, mostly toward the negative, and from experience know that these types of surveys are far more likely to be used to jack up insurance premiums or deny life insurance (for instance, I've been denied life insurance by my husband's company because I consulted a doctor for depression and anxiety).
This is for diagnosing illness, nothing to do with insurance.0 -
NorthCascades wrote: »lporter229 wrote: »I think it makes sense to pay attention to aerobic fitness level as a medical indicator. That would provide more insight into how healthy someone is, see if they are deteriorating or improving, etc.
But it seems to me that aerobic fitness doesn't really fit in with the other vital signs. The other ones mentioned - pulse, blood pressure, respiration, and temperature - are all easily and rapidly measurable. They can even be measured when the subject is unconscious. VO2max requires either a stress test or, as discussed in the article, a calculator that is subject to all kinds of uncertainties.
I agree. If the calculator uses an estimated max heart rate based on age related formulas, it's pretty much useless. Using unreliable formulas as a means of diagnosing one's health condition is pretty dangerous, IMO.
Do you think a best guess is worse than no information at all?
From a medical perspective - yes.
Improper diagnosis is one of the leading causes of death. The algorithms are already established and we pull these estimations from pulseox and BP. Not the most accurate means, but useful in initial triage.0 -
The articles I read about this say the greatest risk is at ground zero, and the greatest reduction of risk comes basically at the first step above that. Which suggests to me that a ballpark would be good enough for most basic/general practice things. I assume if this went into practice, a lab test would be administered when more accuracy is required.
To put it in less vague terms: the test might over-estimate my fitness, say credit me with a VO2max of 55 instead of 53 ml/kg/min. Both the actual and wrong value would mean that pain in my leg probably isn't a blood clot.1 -
NorthCascades wrote: »I would honestly hate to see insurance premiums based on a survey like this. I can see so many variables that would skew the results, mostly toward the negative, and from experience know that these types of surveys are far more likely to be used to jack up insurance premiums or deny life insurance (for instance, I've been denied life insurance by my husband's company because I consulted a doctor for depression and anxiety).
This is for diagnosing illness, nothing to do with insurance.
Ah, got it! Then yes, I think it could be a useful tool for assessing overall health in conjunction with the current established vital signs.1 -
NorthCascades wrote: »Not sure about the calculator...it says I have fitness of a 23yr old! (I'm 43) I even did all the extra questions so the calculator knew I have asthma. I'm not sure I believe it as I know my health is poor by my standards. I'm nowhere near where I was just a few years ago.
Your standards are a lot higher than most. Somebody my girlfriend works with was talking about visiting Iceland on a cruise. She'd like to soak in a hot spring, but it's a mile from the road. She explained that it's ok, because they have helicopters (to carry her that mile).
What?! You're joking! A helicopter to go a mile? I'm guessing it wasn't straight up a mile high cliff either.0 -
No. It should be a measure of fitness but it's not a vital sign.
As a nurse who provides emergency care, I will tell you that fitness is not a vital sign.4 -
robinhelmstreit wrote: »No. It should be a measure of fitness but it's not a vital sign.
As a nurse who provides emergency care, I will tell you that fitness is not a vital sign.
Yeah, while fitness is no doubt good, deeming it "vital"..as in essential for maintaining life is a bit of a stretch.1 -
NorthCascades wrote: »Not sure about the calculator...it says I have fitness of a 23yr old! (I'm 43) I even did all the extra questions so the calculator knew I have asthma. I'm not sure I believe it as I know my health is poor by my standards. I'm nowhere near where I was just a few years ago.
Your standards are a lot higher than most. Somebody my girlfriend works with was talking about visiting Iceland on a cruise. She'd like to soak in a hot spring, but it's a mile from the road. She explained that it's ok, because they have helicopters (to carry her that mile).
What?! You're joking! A helicopter to go a mile? I'm guessing it wasn't straight up a mile high cliff either.
I'd assume this was a joke.
I know lots of people who don't really exercise at all (although I also know lots of people who are very active), but absolutely no one who is not quite old or disabled who would find walking a mile anything other than common and normal daily activity.0 -
NorthCascades wrote: »The articles I read about this say the greatest risk is at ground zero, and the greatest reduction of risk comes basically at the first step above that. Which suggests to me that a ballpark would be good enough for most basic/general practice things. I assume if this went into practice, a lab test would be administered when more accuracy is required.
To put it in less vague terms: the test might over-estimate my fitness, say credit me with a VO2max of 55 instead of 53 ml/kg/min. Both the actual and wrong value would mean that pain in my leg probably isn't a blood clot.
This is true and much of medical protocol actually has very little scientific proof behind it. Medical protocols are established because they work in a larger population. It's a bit disturbing viewing this as a medical scientist.
I've used the VO2max calculation using my Polar and found this in line with my clinical results - then I also fit the 80% demographic of those sampled in developing the algorithm. I would imagine the degree of error would expand dramatically in the overweight population.
I'm going to suggest adding this to our triage and see what results we get.0 -
NorthCascades wrote: »Not sure about the calculator...it says I have fitness of a 23yr old! (I'm 43) I even did all the extra questions so the calculator knew I have asthma. I'm not sure I believe it as I know my health is poor by my standards. I'm nowhere near where I was just a few years ago.
Your standards are a lot higher than most. Somebody my girlfriend works with was talking about visiting Iceland on a cruise. She'd like to soak in a hot spring, but it's a mile from the road. She explained that it's ok, because they have helicopters (to carry her that mile).
What?! You're joking! A helicopter to go a mile? I'm guessing it wasn't straight up a mile high cliff either.
In Iceland, it just might be. The terrain there can be fairly aggressive.1
This discussion has been closed.
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