Abstract

In an era where chronic diseases and sedentary lifestyles are prevalent, a new, measurable indicator of cardiovascular fitness is needed. This paper explores VO₂max (maximal oxygen uptake) as a central biomarker and modifiable determinant of healthspan and longevity. VO₂max reflects the integrated efficiency of the cardiovascular, respiratory, and muscular systems in transporting and utilizing oxygen during exercise. As the increased efficiency of the heart, lungs, blood vessels, and muscles not only benefits VO₂max, but also a measurable increase in mitochondrial density and muscle endurance occurs. As a result, across decades of research, higher VO₂max has been consistently linked to reduced all-cause mortality, lower incidence of cardiovascular and metabolic diseases, and improved cognitive outcomes in older age. In the paper published by Clausen et al., the research is solidified, as it evaluates individuals over a 46-year period, demonstrating that higher midlife VO₂max can decrease mortality by 50%. This review examines physiological mechanisms connecting VO₂max with aging, summarizes epidemiological and neurobiological evidence, and evaluates its role as a clinical “vital sign.” The paper states that improving cardiorespiratory fitness (CRF) provides an evidence-based strategy to extend healthspan and delay the onset of chronic diseases such as type 2 diabetes, cardiovascular disease, and dementia. Regular screenings of VO₂max or cardiorespiratory fitness in at-risk populations would enable physicians to prevent illnesses before they develop. Recognizing VO₂max as a vital sign could help reframe fitness as a cornerstone of preventative medicine. 

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