Association Between Cardiorespiratory Fitness and Healthcare Costs

  • Jonathan Myers
  • Peter KokkinosEmail author


Numerous recent studies have documented the importance of cardiorespiratory fitness (CRF) in the risk paradigm among subjects both with and without chronic disease. In fact, in many recent studies, CRF has been shown to be a more powerful risk marker than the traditional risk factors for cardiovascular disease. These observations have been an impetus to include fitness as one of the primary “vital signs” along with the traditional risk markers that include hypertension, lipid abnormalities, smoking, obesity, and diabetes. These studies have also led to increasing efforts to promote physical activity through employer-based worksite wellness programs, which have been consistently shown to have a positive economic impact. However, less is known regarding the association between objective measures of CRF and healthcare costs. In recent years, a limited number of studies have provided insight into this issue. Although quantifying healthcare costs is challenging, these studies are consistent in the demonstration that higher CRF is associated with lower healthcare costs. A small increment in CRF appears to have a major impact on costs; each 1-MET higher CRF level is associated with 5–7% reductions in healthcare costs. These studies are also consistent when adjusted for potentially confounding factors, are not altered appreciably by including or excluding patients with cardiovascular disease, and appear to be more pronounced among overweight and obese subjects, and CRF appears to be a powerful predictor of healthcare costs. Thus, efforts to improve CRF not only have a favorable impact on health outcomes, but they also result in lower healthcare costs. The purpose of this chapter is to review the available literature addressing the association between CRF and healthcare costs.


Cardiorespiratory fitness Healthcare cost CRF Chronic illnesses Association 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of CardiologyVA Palo Alto Health Care System/Stanford UniversityPalo AltoUSA
  2. 2.Veterans Affairs Medical Center, Department of CardiologyWashington, DCUSA
  3. 3.Georgetown University School of MedicineWashington, DCUSA
  4. 4.Department of Kinesiology and HealthRutgers UniversityNew BrunswickUSA
  5. 5.George Washington University School of Medicine and Health SciencesWashington, DCUSA
  6. 6.University of South Carolina, Department of Exercise Science, Arnold School of Public HealthColumbiaUSA

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