Pediatric Cardiology

, Volume 40, Issue 6, pp 1183–1189 | Cite as

Comparative Cardiorespiratory Fitness in Children: Racial Disparity May Begin Early in Childhood

  • Neha BansalEmail author
  • Deemah R. Mahadin
  • Roxann Smith
  • Michelle French
  • Peter P. Karpawich
  • Sanjeev Aggarwal
Original Article


African American (AA) adults are reported to have lower levels of cardiorespiratory fitness (CRF) as compared to Caucasian adults. CRF is linked to cardiovascular morbidity and mortality. We hypothesized that the disparities start early in childhood. This was a retrospective analysis of the cardiopulmonary exercise test (CPET). We included normal healthy children, ≤ 18 years of age, who had normal electrocardiograms and normal cardiac function. We excluded patients with congenital heart disease, obesity and suboptimal exercise test. The entire cohort was divided into two groups based on race (Caucasian vs. AA) and then further subcategorized by gender. The cohort of 248 patients had a mean ± SD age of 14.4 ± 2.1 years. 158 (60.8%) were males and 158 (60.8%) were Caucasians. Oxygen consumption was higher among Caucasian children when compared to the AA children (48.7 ± 7.9 vs. 45.4 ± 7 mL/kg/min, p = 0.01). This racial disparity continued to persist when comparisons were performed separately for girls and boys. Upon comparing the four groups, the AA females were found to have the lowest values of VO2max, exercise time and METS (p = 0.001). Thus, in conclusion, the AA children have significantly lower level of CRF, as measured by VO2max and exercise time. The racial disparity is independent of gender. African American females show the lowest level of aerobic capacity. The findings of our study suggest that the racial disparity in the CRF levels seen in the adult population may begin early in childhood.


Racial disparity Cardiorespiratory fitness Pediatric exercise Exercise stress testing 


Compliance with Ethical Standards

Conflicts of interest

The authors have no conflicts of interest relevant to this article to disclose.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors. The study was retrospective chart review.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Pediatric CardiologyChildren’s Hospital at MontefioreBronxUSA
  2. 2.Division of Pediatric CardiologyThe Children’s Hospital of MichiganDetroitUSA

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