Cardiorespiratory fitness and ideal cardiovascular health in European adolescents

Objective We studied in European adolescents (i) the association between cardiorespiratory fitness and ideal cardiovascular health as defined by the American Heart Association and (ii) whether there is a cardiorespiratory fitness threshold associated with a more favourable cardiovascular health profile. Methods Participants included 510 (n=259 girls) adolescents from 9 European countries. The 20 m shuttle run test was used to estimate cardiorespiratory fitness. Ideal cardiovascular health was defined as meeting ideal levels of the following components: four behaviours (smoking, body mass index, physical activity and diet) and three factors (total cholesterol, blood pressure and glucose). Results Higher levels of cardiorespiratory fitness were associated with a higher number of ideal cardiovascular health components in both boys and girls (both p for trend ≤0.001). Levels of cardiorespiratory fitness were significantly higher in adolescents meeting at least four ideal components (13% higher in boys, p<0.001; 6% higher in girls, p=0.008). Receiver operating characteristic curve analyses showed a significant discriminating accuracy of cardiorespiratory fitness in identifying the presence of at least four ideal cardiovascular health components (43.8 mL/kg/min in boys and 34.6 mL/kg/min in girls, both p<0.001). Conclusions The results suggest a hypothetical cardiorespiratory fitness level associated with a healthier cardiovascular profile in adolescents. The fitness standards could be used in schools as part of surveillance and/or screening systems to identify youth with poor health behaviours who might benefit from intervention programmes.